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Published in: Breast Cancer 4/2016

01-07-2016 | Original Article

Diagnostic performance of 18F-fluorodeoxyglucose PET/CT and bone scintigraphy in breast cancer patients with suspected bone metastasis

Authors: Naoki Niikura, Jun Hashimoto, Toshiki Kazama, Jun Koizumi, Rin Ogiya, Mayako Terao, Risa Oshitanai, Toru Morioka, Banri Tsuda, Takuho Okamura, Yuki Saito, Keiko Iwaisako, Takayuki Iwamoto, Naoki Hayashi, Yutaka Imai, Yutaka Tokuda

Published in: Breast Cancer | Issue 4/2016

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Abstract

Background

We prospectively compared the diagnostic accuracies of PET/CT and BS in patients with suspected bone metastases from breast cancer.

Methods

This single-institution prospective study included consecutive patients with suspected bone metastases from biopsy-proven breast cancer seen at Tokai University Hospital between September 2011 and March 2014. Inclusion criteria included suspicions for bone metastases (bone pain, elevated alkaline phosphatase, elevated tumor markers, or suspected bone metastases by BS). Two nuclear medicine physicians evaluated PET/CT and BS images.

Results

Thirty patients were initially enrolled in this study. Two were excluded from the analyses because they declined to undergo imaging during follow-up. PET/CT successfully detected bone metastases in all 10 patients finally diagnosed with the condition, whereas BS identified 2. The two methods were not highly concordant in detecting osseous metastases. In 19 of 28 paired studies (68 %), 2 (10 %) were positive for metastasis, and 17 (90 %) were negative. Nine occurrences (32 %) were discordant; of these, 2 were PET/CT positive and BS negative; 5 were PET/CT positive and BS equivocal; one was PET/CT negative and BS equivocal, and one was PET/CT equivocal and BS negative.

Conclusions

Our results indicated that PET/CT was superior to BS for the diagnosis of bone metastases. On the basis of the results of previous studies as well as ours, PET/CT could replace BS as the initial modality to detect bone metastases in patients suspected for the condition.
Literature
1.
2.
go back to reference Niikura N, Liu J, Hayashi N, Palla SL, Tokuda Y, Hortobagyi GN, et al. Treatment outcome and prognostic factors for patients with bone-only metastases of breast cancer: a single-institution retrospective analysis. Oncologist. 2011;16:155–64.CrossRefPubMedPubMedCentral Niikura N, Liu J, Hayashi N, Palla SL, Tokuda Y, Hortobagyi GN, et al. Treatment outcome and prognostic factors for patients with bone-only metastases of breast cancer: a single-institution retrospective analysis. Oncologist. 2011;16:155–64.CrossRefPubMedPubMedCentral
3.
4.
go back to reference Domchek SM, Younger J, Finkelstein DM, Seiden MV. Predictors of skeletal complications in patients with metastatic breast carcinoma. Cancer. 2000;89:363–8.CrossRefPubMed Domchek SM, Younger J, Finkelstein DM, Seiden MV. Predictors of skeletal complications in patients with metastatic breast carcinoma. Cancer. 2000;89:363–8.CrossRefPubMed
5.
go back to reference Briasoulis E, Karavasilis V, Kostadima L, Ignatiadis M, Fountzilas G, Pavlidis N. Metastatic breast carcinoma confined to bone: portrait of a clinical entity. Cancer. 2004;101:1524–8.CrossRefPubMed Briasoulis E, Karavasilis V, Kostadima L, Ignatiadis M, Fountzilas G, Pavlidis N. Metastatic breast carcinoma confined to bone: portrait of a clinical entity. Cancer. 2004;101:1524–8.CrossRefPubMed
6.
go back to reference Roberts CC, Daffner RH, Weissman BN, Bancroft L, Bennett DL, Blebea JS, et al. ACR appropriateness criteria on metastatic bone disease. J Am Coll Radiol. 2010;7:400–9.CrossRefPubMed Roberts CC, Daffner RH, Weissman BN, Bancroft L, Bennett DL, Blebea JS, et al. ACR appropriateness criteria on metastatic bone disease. J Am Coll Radiol. 2010;7:400–9.CrossRefPubMed
7.
go back to reference Costelloe CM, Rohren EM, Madewell JE, Hamaoka T, Theriault RL, Yu TK, et al. Imaging bone metastases in breast cancer: techniques and recommendations for diagnosis. Lancet Oncol. 2009;10:606–14.CrossRefPubMed Costelloe CM, Rohren EM, Madewell JE, Hamaoka T, Theriault RL, Yu TK, et al. Imaging bone metastases in breast cancer: techniques and recommendations for diagnosis. Lancet Oncol. 2009;10:606–14.CrossRefPubMed
8.
go back to reference Tryciecky EW, Gottschalk A, Ludema K. Oncologic imaging: interactions of nuclear medicine with CT and MRI using the bone scan as a model. Semin Nucl Med. 1997;27:142–51.CrossRefPubMed Tryciecky EW, Gottschalk A, Ludema K. Oncologic imaging: interactions of nuclear medicine with CT and MRI using the bone scan as a model. Semin Nucl Med. 1997;27:142–51.CrossRefPubMed
10.
go back to reference Abe K, Sasaki M, Kuwabara Y, Koga H, Baba S, Hayashi K, et al. Comparison of 18FDG-PET with 99mTc-HMDP scintigraphy for the detection of bone metastases in patients with breast cancer. Ann Nucl Med. 2005;19:573–9.CrossRefPubMed Abe K, Sasaki M, Kuwabara Y, Koga H, Baba S, Hayashi K, et al. Comparison of 18FDG-PET with 99mTc-HMDP scintigraphy for the detection of bone metastases in patients with breast cancer. Ann Nucl Med. 2005;19:573–9.CrossRefPubMed
11.
go back to reference Shie P, Cardarelli R, Brandon D, Erdman W, Abdulrahim N. Meta-analysis: comparison of F-18 Fluorodeoxyglucose-positron emission tomography and bone scintigraphy in the detection of bone metastases in patients with breast cancer. Clin Nucl Med. 2008;33:97–101.CrossRefPubMed Shie P, Cardarelli R, Brandon D, Erdman W, Abdulrahim N. Meta-analysis: comparison of F-18 Fluorodeoxyglucose-positron emission tomography and bone scintigraphy in the detection of bone metastases in patients with breast cancer. Clin Nucl Med. 2008;33:97–101.CrossRefPubMed
12.
go back to reference Cook GJ, Houston S, Rubens R, Maisey MN, Fogelman I. Detection of bone metastases in breast cancer by 18FDG PET: differing metabolic activity in osteoblastic and osteolytic lesions. J Clin Oncol. 1998;16:3375–9.PubMed Cook GJ, Houston S, Rubens R, Maisey MN, Fogelman I. Detection of bone metastases in breast cancer by 18FDG PET: differing metabolic activity in osteoblastic and osteolytic lesions. J Clin Oncol. 1998;16:3375–9.PubMed
13.
go back to reference Du Y, Cullum I, Illidge TM, Ell PJ. Fusion of metabolic function and morphology: sequential [18F]fluorodeoxyglucose positron-emission tomography/computed tomography studies yield new insights into the natural history of bone metastases in breast cancer. J Clin Oncol. 2007;25:3440–7.CrossRefPubMed Du Y, Cullum I, Illidge TM, Ell PJ. Fusion of metabolic function and morphology: sequential [18F]fluorodeoxyglucose positron-emission tomography/computed tomography studies yield new insights into the natural history of bone metastases in breast cancer. J Clin Oncol. 2007;25:3440–7.CrossRefPubMed
14.
go back to reference Gebhart G, Gamez C, Holmes E, Robles J, Garcia C, Cortes M, et al. 18F-FDG PET/CT for early prediction of response to neoadjuvant lapatinib, trastuzumab, and their combination in HER2-positive breast cancer: results from Neo-ALTTO. J Nucl Med. 2013;54:1862–8.CrossRefPubMed Gebhart G, Gamez C, Holmes E, Robles J, Garcia C, Cortes M, et al. 18F-FDG PET/CT for early prediction of response to neoadjuvant lapatinib, trastuzumab, and their combination in HER2-positive breast cancer: results from Neo-ALTTO. J Nucl Med. 2013;54:1862–8.CrossRefPubMed
15.
go back to reference Groheux D, Giacchetti S, Hatt M, Marty M, Vercellino L, de Roquancourt A, et al. HER2-overexpressing breast cancer: FDG uptake after two cycles of chemotherapy predicts the outcome of neoadjuvant treatment. Br J Cancer. 2013;109:1157–64.CrossRefPubMedPubMedCentral Groheux D, Giacchetti S, Hatt M, Marty M, Vercellino L, de Roquancourt A, et al. HER2-overexpressing breast cancer: FDG uptake after two cycles of chemotherapy predicts the outcome of neoadjuvant treatment. Br J Cancer. 2013;109:1157–64.CrossRefPubMedPubMedCentral
16.
go back to reference Fuster D, Duch J, Paredes P, Velasco M, Munoz M, Santamaria G, et al. Preoperative staging of large primary breast cancer with [18F]fluorodeoxyglucose positron emission tomography/computed tomography compared with conventional imaging procedures. J Clin Oncol. 2008;26:4746–51.CrossRefPubMed Fuster D, Duch J, Paredes P, Velasco M, Munoz M, Santamaria G, et al. Preoperative staging of large primary breast cancer with [18F]fluorodeoxyglucose positron emission tomography/computed tomography compared with conventional imaging procedures. J Clin Oncol. 2008;26:4746–51.CrossRefPubMed
17.
go back to reference Rong J, Wang S, Ding Q, Yun M, Zheng Z, Ye S. Comparison of 18 FDG PET-CT and bone scintigraphy for detection of bone metastases in breast cancer patients. A meta-analysis. Surg Oncol. 2013;22:86–91.CrossRefPubMed Rong J, Wang S, Ding Q, Yun M, Zheng Z, Ye S. Comparison of 18 FDG PET-CT and bone scintigraphy for detection of bone metastases in breast cancer patients. A meta-analysis. Surg Oncol. 2013;22:86–91.CrossRefPubMed
18.
go back to reference Morris PG, Lynch C, Feeney JN, Patil S, Howard J, Larson SM, et al. Integrated positron emission tomography/computed tomography may render bone scintigraphy unnecessary to investigate suspected metastatic breast cancer. J Clin Oncol. 2010;28:3154–9.CrossRefPubMedPubMedCentral Morris PG, Lynch C, Feeney JN, Patil S, Howard J, Larson SM, et al. Integrated positron emission tomography/computed tomography may render bone scintigraphy unnecessary to investigate suspected metastatic breast cancer. J Clin Oncol. 2010;28:3154–9.CrossRefPubMedPubMedCentral
19.
go back to reference Niikura N, Costelloe CM, Madewell JE, Hayashi N, Yu TK, Liu J, et al. FDG-PET/CT compared with conventional imaging in the detection of distant metastases of primary breast cancer. Oncologist. 2011;16:1111–9.CrossRefPubMedPubMedCentral Niikura N, Costelloe CM, Madewell JE, Hayashi N, Yu TK, Liu J, et al. FDG-PET/CT compared with conventional imaging in the detection of distant metastases of primary breast cancer. Oncologist. 2011;16:1111–9.CrossRefPubMedPubMedCentral
20.
go back to reference Houssami N, Costelloe CM. Imaging bone metastases in breast cancer: evidence on comparative test accuracy. Ann Oncol. 2012;23:834–43.CrossRefPubMed Houssami N, Costelloe CM. Imaging bone metastases in breast cancer: evidence on comparative test accuracy. Ann Oncol. 2012;23:834–43.CrossRefPubMed
21.
go back to reference Ohta M, Tokuda Y, Suzuki Y, Kubota M, Makuuchi H, Tajima T, et al. Whole body PET for the evaluation of bony metastases in patients with breast cancer: comparison with 99Tcm-MDP bone scintigraphy. Nucl Med Commun. 2001;22:875–9.CrossRefPubMed Ohta M, Tokuda Y, Suzuki Y, Kubota M, Makuuchi H, Tajima T, et al. Whole body PET for the evaluation of bony metastases in patients with breast cancer: comparison with 99Tcm-MDP bone scintigraphy. Nucl Med Commun. 2001;22:875–9.CrossRefPubMed
22.
go back to reference Nakamoto Y, Cohade C, Tatsumi M, Hammoud D, Wahl RL. CT appearance of bone metastases detected with FDG PET as part of the same PET/CT examination. Radiology. 2005;237:627–34.CrossRefPubMed Nakamoto Y, Cohade C, Tatsumi M, Hammoud D, Wahl RL. CT appearance of bone metastases detected with FDG PET as part of the same PET/CT examination. Radiology. 2005;237:627–34.CrossRefPubMed
23.
go back to reference Hamaoka T, Madewell JE, Podoloff DA, Hortobagyi GN, Ueno NT. Bone imaging in metastatic breast cancer. J Clin Oncol. 2004;22:2942–53.CrossRefPubMed Hamaoka T, Madewell JE, Podoloff DA, Hortobagyi GN, Ueno NT. Bone imaging in metastatic breast cancer. J Clin Oncol. 2004;22:2942–53.CrossRefPubMed
24.
go back to reference Niikura N, Odisio BC, Tokuda Y, Symmans FW, Hortobagyi GN, Ueno NT. Latest biopsy approach for suspected metastases in patients with breast cancer. Nat Rev Clin Oncol. 2013;10:711–9.CrossRefPubMed Niikura N, Odisio BC, Tokuda Y, Symmans FW, Hortobagyi GN, Ueno NT. Latest biopsy approach for suspected metastases in patients with breast cancer. Nat Rev Clin Oncol. 2013;10:711–9.CrossRefPubMed
Metadata
Title
Diagnostic performance of 18F-fluorodeoxyglucose PET/CT and bone scintigraphy in breast cancer patients with suspected bone metastasis
Authors
Naoki Niikura
Jun Hashimoto
Toshiki Kazama
Jun Koizumi
Rin Ogiya
Mayako Terao
Risa Oshitanai
Toru Morioka
Banri Tsuda
Takuho Okamura
Yuki Saito
Keiko Iwaisako
Takayuki Iwamoto
Naoki Hayashi
Yutaka Imai
Yutaka Tokuda
Publication date
01-07-2016
Publisher
Springer Japan
Published in
Breast Cancer / Issue 4/2016
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-015-0621-z

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