Skeletal metastasis detection with 99mTc-MDP bone scan and 18-F-FDG PET/CT scan in breast cancer patients
Journal
European journal of nuclear medicine and molecular imaging
Date Issued
2021
Author(s)
Besliev S.
Bozinovska N.
DOI
10.1007/s00259-021-05547-1
Abstract
Aim/Introduction: Breast cancer is the most commonly-
diagnosed cancer worldwide in females. Skeleton is the most
common site of metastasis spread (for breast cancer). Bone
scan (BS) is a widely used, non-invasive nuclear medicine
diagnostic tool for detecting bone metastasis (BM) in the
early phase of the disease as well as after therapy. Although
hybrid PET/CT imaging are more considered for staging
and restaging the disease as well as evaluating treatment
response, BS is still keeping its position as a highly sensitive
method in detecting bone metastasis. The aim of our study
was to compare the findings of bone scan and FDG-PET/
CT scan for detection of BM in breast cancer patients at
initial staging of the disease. Materials and Methods: We
retrospectively analyzed 25 patients with breast cancer who
underwent both BS and PET/CT scan for detecting BM in the
period 2019-2020. Whole body BS was performed 3 hours after
iv injection of 740 MBq 99mTc-MDP. PET/CT was performed
after 60 minutes of iv injection of 18F-FDG in accordance
with standard protocols. Results: 25 patients were included
in the study (age 53,56±11,55 years). BM affected both axial
and appendicular skeleton in (n=7, 38,88%), axial skeleton
only was affected in 8pts, while appendicular only in (n=4,
22,2%). Solitary metastases were detected in 5 pts, 3pts had
2 BM, 10pts had three or more BM. From all 25 patients, 7 pts
(41,17%) had negative findings for BM with both methods,
while 18 patients had positive findings with both methods.
Among these positive findings, 10 patients (n=10/18; 55,55%)
had identical metastatic bone foci detected with both
methods. On the other hand, PET/CT scan revealed more
foci of bone metastasis than BS in (n=7/18 patients; 38,88%),
depicting BM in scapula, spine, sternum and iliac bones in
different patients, that were not seen on bone scan. Bone
scan presented more BM foci in only (n=2/18 patients; 11,1%).
Patients with normal findings on BS did not reveal BM on PET/
CT scan which means there is a good correlation regarding
false negative findings with both methods. Conclusion: BS
and 18F-FDG-PET/CT are complementary modalities that are
highly sensitive in evaluating BM in breast cancer patients.
Hybrid imaging (SPECT/CT and PET/CT) because of the
complementary value of CT may contribute to the diagnosis
of BM. Bone scan is widely used, low cost, easy to perform
diagnostic modality and remains the method of choice for
detection of bone metastasis.
diagnosed cancer worldwide in females. Skeleton is the most
common site of metastasis spread (for breast cancer). Bone
scan (BS) is a widely used, non-invasive nuclear medicine
diagnostic tool for detecting bone metastasis (BM) in the
early phase of the disease as well as after therapy. Although
hybrid PET/CT imaging are more considered for staging
and restaging the disease as well as evaluating treatment
response, BS is still keeping its position as a highly sensitive
method in detecting bone metastasis. The aim of our study
was to compare the findings of bone scan and FDG-PET/
CT scan for detection of BM in breast cancer patients at
initial staging of the disease. Materials and Methods: We
retrospectively analyzed 25 patients with breast cancer who
underwent both BS and PET/CT scan for detecting BM in the
period 2019-2020. Whole body BS was performed 3 hours after
iv injection of 740 MBq 99mTc-MDP. PET/CT was performed
after 60 minutes of iv injection of 18F-FDG in accordance
with standard protocols. Results: 25 patients were included
in the study (age 53,56±11,55 years). BM affected both axial
and appendicular skeleton in (n=7, 38,88%), axial skeleton
only was affected in 8pts, while appendicular only in (n=4,
22,2%). Solitary metastases were detected in 5 pts, 3pts had
2 BM, 10pts had three or more BM. From all 25 patients, 7 pts
(41,17%) had negative findings for BM with both methods,
while 18 patients had positive findings with both methods.
Among these positive findings, 10 patients (n=10/18; 55,55%)
had identical metastatic bone foci detected with both
methods. On the other hand, PET/CT scan revealed more
foci of bone metastasis than BS in (n=7/18 patients; 38,88%),
depicting BM in scapula, spine, sternum and iliac bones in
different patients, that were not seen on bone scan. Bone
scan presented more BM foci in only (n=2/18 patients; 11,1%).
Patients with normal findings on BS did not reveal BM on PET/
CT scan which means there is a good correlation regarding
false negative findings with both methods. Conclusion: BS
and 18F-FDG-PET/CT are complementary modalities that are
highly sensitive in evaluating BM in breast cancer patients.
Hybrid imaging (SPECT/CT and PET/CT) because of the
complementary value of CT may contribute to the diagnosis
of BM. Bone scan is widely used, low cost, easy to perform
diagnostic modality and remains the method of choice for
detection of bone metastasis.