Combined PET/CT Scanning Can Change the Management of High-Risk Cancers

The results of a new study show that PET/CT and whole body MRI scanning can be used to change the management of high-risk breast and prostate cancer patients.

The study was published in the December 2015, issue of the Journal of Nuclear Medicine and indicated that Positron Emission Tomography/Computed Tomography (PET/CT) and whole-body Magnetic Resonance Imaging (MRI) could detect extra-skeletal disease and change the management of high-risk breast and prostate cancer patients. The administration of F-18 sodium fluoride (NaF) and F-18 fluorodeoxyglucose (FDG) in a single PET/CT scan also provided significantly higher accuracy, and sensitivity for the detection of skeletal lesions.

The study group consisted of patients with breast or prostate cancers and compared results of the combined use of F-18 NaF/F-18 FDG PET/CT, to those obtained with Tc-99m MDP Bone Scintigraphy (BS) and Whole-Body MRI (WBMRI). The study included 15 women with breast cancer, and 15 men with prostate cancer that had been referred for standard of care BS and subsequently underwent NaF/FDG PET/CT and WBMRI. According to the results of the preliminary study NaF/FDG PET/CT was significantly more accurate in detecting skeletal lesions than WBMRI and Tc-99m MDP scintigraphy, and NaF/FDG PET/CT and WBMRI were able to detect extra-skeletal disease, and could change the way high-risk breast and prostate cancer patients treatment are managed.

Corresponding author of the study Andrei H. Iagaru, MD, FACNM, co-chief of the Stanford University (Stanford, CA, USA) division of Nuclear Medicine and Molecular Imaging, and co-director of the PET-MRI research program, said, "Using results from previous studies, this project attempts to identify the most appropriate approach for identifying lesions in selected breast and prostate cancer patients who are at high risk of developing metastatic disease. More work remains to be done, and our group is now exploring the use of combined NaF/FDG injections with state of the art PET/MRI technology for significant decreases in radiation exposure and improved diagnostic performance in accurately evaluating extent of disease in cancer patients.”

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