Combined 18F-Fluoride and 18F-FDG PET/CT scanning for evaluation of malignancy: Results of an international multicenter trial

Abstract

18F-FDG PET/CT is used in a variety of cancers, but because of variable rates of glucose metabolism, not all cancers are reliably identified. 18F- PET/CT allows for the acquisition of highly sensitive and specific images of the skeleton. We prospectively evaluated combined 18F-/18F-FDG as a single PET/CT examination for evaluation of cancer patients and compared it with separate 18F - PET/CT and 18F-FDG PET/CT scans. Methods: One hundred fifteen participants with cancer were prospectively enrolled in an international multicenter trial evaluating 18F- PET/CT, 18F-FDG PET/CT, and combined 18F-/ 18F-FDG PET/CT. The 3 PET/CT scans were performed sequentially within 4 wk of one another for each patient. Results: 18F-/ 18FFDG PET/CT allowed for accurate interpretation of radiotracer uptake outside the skeleton, with findings similar to those of 18F-FDG PET/CT. In 19 participants, skeletal disease was more extensive on 18F- PET/CT and 18F -/18F-FDG PET/CT than on 18F-FDG PET/CT. In another 29 participants, 18F- PET/CT and 18F-/18F-FDG PET/CT showed osseous metastases where 18FFDG PET/CT was negative. The extent of skeletal lesions was similar in 18 participants on all 3 scans. Conclusion: This trial demonstrated that combined 18F-/18F-FDG PET/CT shows promising results when compared with separate 18F- PET/CT and 18F-FDG PET/CT for evaluation of cancer patients. This result opens the possibility for improved patient care and reduction in health-care costs, as will be further evaluated in future trials. Copyright © 2013 by the Society of Nuclear Medicine and Molecular Imaging, Inc.