Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer

Randi Fuglsang Fonager; Helle Damgaard Zacho; Niels Christian Langkilde; Joan Fledelius; June Anita Ejlersen; Helle Westergreen Hendel; Christian Haarmark; Mette Moe; Jesper Carl Mortensen; Mads Ryø Jochumsen; Lars Jelstrup Petersen

doi:10.1080/0284186x.2018.1438651

Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer

Randi Fuglsang Fonager, Helle Damgaard Zacho, Niels Christian Langkilde, Joan Fledelius, June Anita Ejlersen, Helle Westergreen Hendel, Christian Haarmark, Mette Moe, Jesper Carl Mortensen, Mads Ryø Jochumsen, Lars Jelstrup Petersen

Institut for Klinisk Medicin

4 Citationer (Scopus)

Abstract

AIM: To compare 18F-sodium fluoride positron emission tomography/computed tomography (NaF PET/CT) and 99mTc-labelled diphosphonate bone scan (BS) for the monitoring of bone metastases in patients with prostate cancer undergoing anti-cancer treatment.

MATERIAL AND METHODS: Data from 64 patients with prostate cancer were included. The patients received androgen-deprivation therapy (ADT), next-generation hormonal therapy (NGH) or chemotherapy. The patients had a baseline scan and 1-3 subsequent scans during six months of treatment. Images were evaluated by experienced nuclear medicine physicians and classified for progressive disease (PD) or non-PD according to the Prostate Cancer Working Group 2 (PCWG-2) criteria. The patients were also classified as having PD/non-PD according to the clinical and prostate-specific antigen (PSA) responses.

RESULTS: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD during treatment (McNemar's test, p = .18). The agreement between BS and NaF PET/CT for PD/non-PD was moderate (Cohen's kappa 0.53, 95% confidence interval 0.26-0.79). Crude agreement between BS and NaF PET/CT for the assessment of PD/non-PD was 86% (89% for ADT, n = 28; 88% for NGH, n = 16, and 80% for chemotherapy, n = 20). In most discordant cases, BS found PD when NaF PET/CT did not, or BS detected PD on an earlier scan than NaF PET/CT. Biochemical progression (27%) occurred more frequently than progression on functional imaging (BS, 22% and NaF PET/CT, 14%). Clinical progression was rare (11%), and almost exclusively seen in patients receiving chemotherapy.

CONCLUSION: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD; however, BS seemingly detects PD by the PCWG-2 criteria earlier than NaF-PET, which might be explained by the fact that NaF-PET is more sensitive at the baseline scan.

Originalsprog	Engelsk
Tidsskrift	Acta Oncologica
Vol/bind	57
Udgave nummer	8
Sider (fra-til)	1063-1069
Antal sider	7
ISSN	0284-186X
DOI	https://doi.org/10.1080/0284186x.2018.1438651
Status	Udgivet - 3 aug. 2018

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10.1080/0284186x.2018.1438651

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Fonager, R. F., Zacho, H. D., Langkilde, N. C., Fledelius, J., Ejlersen, J. A., Hendel, H. W., Haarmark, C., Moe, M., Mortensen, J. C., Jochumsen, M. R., & Petersen, L. J. (2018). Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer. Acta Oncologica, 57(8), 1063-1069. https://doi.org/10.1080/0284186x.2018.1438651

Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer. / Fonager, Randi Fuglsang; Zacho, Helle Damgaard; Langkilde, Niels Christian et al.

I: Acta Oncologica, Bind 57, Nr. 8, 03.08.2018, s. 1063-1069.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Fonager, RF, Zacho, HD, Langkilde, NC, Fledelius, J, Ejlersen, JA, Hendel, HW, Haarmark, C, Moe, M, Mortensen, JC, Jochumsen, MR & Petersen, LJ 2018, 'Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer', Acta Oncologica, bind 57, nr. 8, s. 1063-1069. https://doi.org/10.1080/0284186x.2018.1438651

@article{c5befb27ba084f00809c50bb34fedf0e,

title = "Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer",

abstract = "AIM: To compare 18F-sodium fluoride positron emission tomography/computed tomography (NaF PET/CT) and 99mTc-labelled diphosphonate bone scan (BS) for the monitoring of bone metastases in patients with prostate cancer undergoing anti-cancer treatment.MATERIAL AND METHODS: Data from 64 patients with prostate cancer were included. The patients received androgen-deprivation therapy (ADT), next-generation hormonal therapy (NGH) or chemotherapy. The patients had a baseline scan and 1-3 subsequent scans during six months of treatment. Images were evaluated by experienced nuclear medicine physicians and classified for progressive disease (PD) or non-PD according to the Prostate Cancer Working Group 2 (PCWG-2) criteria. The patients were also classified as having PD/non-PD according to the clinical and prostate-specific antigen (PSA) responses.RESULTS: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD during treatment (McNemar's test, p = .18). The agreement between BS and NaF PET/CT for PD/non-PD was moderate (Cohen's kappa 0.53, 95% confidence interval 0.26-0.79). Crude agreement between BS and NaF PET/CT for the assessment of PD/non-PD was 86% (89% for ADT, n = 28; 88% for NGH, n = 16, and 80% for chemotherapy, n = 20). In most discordant cases, BS found PD when NaF PET/CT did not, or BS detected PD on an earlier scan than NaF PET/CT. Biochemical progression (27%) occurred more frequently than progression on functional imaging (BS, 22% and NaF PET/CT, 14%). Clinical progression was rare (11%), and almost exclusively seen in patients receiving chemotherapy.CONCLUSION: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD; however, BS seemingly detects PD by the PCWG-2 criteria earlier than NaF-PET, which might be explained by the fact that NaF-PET is more sensitive at the baseline scan.",

keywords = "Aged, Aged, 80 and over, Bone Neoplasms/diagnostic imaging, Fluorine Radioisotopes, Humans, Male, Middle Aged, Positron Emission Tomography Computed Tomography/methods, Prospective Studies, Prostatic Neoplasms/drug therapy, Radionuclide Imaging/methods, Radiopharmaceuticals, Sodium Fluoride, Treatment Outcome",

author = "Fonager, {Randi Fuglsang} and Zacho, {Helle Damgaard} and Langkilde, {Niels Christian} and Joan Fledelius and Ejlersen, {June Anita} and Hendel, {Helle Westergreen} and Christian Haarmark and Mette Moe and Mortensen, {Jesper Carl} and Jochumsen, {Mads Ry{\o}} and Petersen, {Lars Jelstrup}",

year = "2018",

month = aug,

day = "3",

doi = "10.1080/0284186x.2018.1438651",

language = "English",

volume = "57",

pages = "1063--1069",

journal = "Acta Oncologica, Supplement",

issn = "1100-1704",

publisher = "Taylor & Francis",

number = "8",

}

TY - JOUR

T1 - Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer

AU - Fonager, Randi Fuglsang

AU - Zacho, Helle Damgaard

AU - Langkilde, Niels Christian

AU - Fledelius, Joan

AU - Ejlersen, June Anita

AU - Hendel, Helle Westergreen

AU - Haarmark, Christian

AU - Moe, Mette

AU - Mortensen, Jesper Carl

AU - Jochumsen, Mads Ryø

AU - Petersen, Lars Jelstrup

PY - 2018/8/3

Y1 - 2018/8/3

N2 - AIM: To compare 18F-sodium fluoride positron emission tomography/computed tomography (NaF PET/CT) and 99mTc-labelled diphosphonate bone scan (BS) for the monitoring of bone metastases in patients with prostate cancer undergoing anti-cancer treatment.MATERIAL AND METHODS: Data from 64 patients with prostate cancer were included. The patients received androgen-deprivation therapy (ADT), next-generation hormonal therapy (NGH) or chemotherapy. The patients had a baseline scan and 1-3 subsequent scans during six months of treatment. Images were evaluated by experienced nuclear medicine physicians and classified for progressive disease (PD) or non-PD according to the Prostate Cancer Working Group 2 (PCWG-2) criteria. The patients were also classified as having PD/non-PD according to the clinical and prostate-specific antigen (PSA) responses.RESULTS: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD during treatment (McNemar's test, p = .18). The agreement between BS and NaF PET/CT for PD/non-PD was moderate (Cohen's kappa 0.53, 95% confidence interval 0.26-0.79). Crude agreement between BS and NaF PET/CT for the assessment of PD/non-PD was 86% (89% for ADT, n = 28; 88% for NGH, n = 16, and 80% for chemotherapy, n = 20). In most discordant cases, BS found PD when NaF PET/CT did not, or BS detected PD on an earlier scan than NaF PET/CT. Biochemical progression (27%) occurred more frequently than progression on functional imaging (BS, 22% and NaF PET/CT, 14%). Clinical progression was rare (11%), and almost exclusively seen in patients receiving chemotherapy.CONCLUSION: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD; however, BS seemingly detects PD by the PCWG-2 criteria earlier than NaF-PET, which might be explained by the fact that NaF-PET is more sensitive at the baseline scan.

AB - AIM: To compare 18F-sodium fluoride positron emission tomography/computed tomography (NaF PET/CT) and 99mTc-labelled diphosphonate bone scan (BS) for the monitoring of bone metastases in patients with prostate cancer undergoing anti-cancer treatment.MATERIAL AND METHODS: Data from 64 patients with prostate cancer were included. The patients received androgen-deprivation therapy (ADT), next-generation hormonal therapy (NGH) or chemotherapy. The patients had a baseline scan and 1-3 subsequent scans during six months of treatment. Images were evaluated by experienced nuclear medicine physicians and classified for progressive disease (PD) or non-PD according to the Prostate Cancer Working Group 2 (PCWG-2) criteria. The patients were also classified as having PD/non-PD according to the clinical and prostate-specific antigen (PSA) responses.RESULTS: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD during treatment (McNemar's test, p = .18). The agreement between BS and NaF PET/CT for PD/non-PD was moderate (Cohen's kappa 0.53, 95% confidence interval 0.26-0.79). Crude agreement between BS and NaF PET/CT for the assessment of PD/non-PD was 86% (89% for ADT, n = 28; 88% for NGH, n = 16, and 80% for chemotherapy, n = 20). In most discordant cases, BS found PD when NaF PET/CT did not, or BS detected PD on an earlier scan than NaF PET/CT. Biochemical progression (27%) occurred more frequently than progression on functional imaging (BS, 22% and NaF PET/CT, 14%). Clinical progression was rare (11%), and almost exclusively seen in patients receiving chemotherapy.CONCLUSION: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD; however, BS seemingly detects PD by the PCWG-2 criteria earlier than NaF-PET, which might be explained by the fact that NaF-PET is more sensitive at the baseline scan.

KW - Aged

KW - Aged, 80 and over

KW - Bone Neoplasms/diagnostic imaging

KW - Fluorine Radioisotopes

KW - Humans

KW - Male

KW - Middle Aged

KW - Positron Emission Tomography Computed Tomography/methods

KW - Prospective Studies

KW - Prostatic Neoplasms/drug therapy

KW - Radionuclide Imaging/methods

KW - Radiopharmaceuticals

KW - Sodium Fluoride

KW - Treatment Outcome

U2 - 10.1080/0284186x.2018.1438651

DO - 10.1080/0284186x.2018.1438651

M3 - Journal article

C2 - 29447047

SN - 1100-1704

VL - 57

SP - 1063

EP - 1069

JO - Acta Oncologica, Supplement

JF - Acta Oncologica, Supplement

IS - 8

ER -

Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer

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