A Comparison of Bone Scan Using between F-18 NaF PET/CT and Tc-99m MDP

Pawana Pusuwan; Tawatchai Ekjeen; Chiraporn Tocharoenchai; Kobkun Maungsomboon; Kanyalak Wiyaporn; Chulalak Komoltri; Ananya Ruangma; Ruentip Tiparoj

doi:10.46475/aseanjr.v19i2.25

Authors

Pawana Pusuwan Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
Tawatchai Ekjeen Department of Radiological Technology, Faculty of Medical Technology, Mahidol University
Chiraporn Tocharoenchai Department of Radiological Technology, Faculty of Medical Technology, Mahidol University
Kobkun Maungsomboon Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
Kanyalak Wiyaporn Department of Radiological Technology, Faculty of Medical Technology, Mahidol University
Chulalak Komoltri Department of Research Development, Faculty of Medicine Siriraj Hospital, Mahidol Univesity
Ananya Ruangma Oncology Imaging & Nuclear Medicine Department, Wattanosoth Hospital, Bangkok Hospital Gro
Ruentip Tiparoj Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University

DOI:

https://doi.org/10.46475/aseanjr.v19i2.25

Keywords:

Bone scan, F-18 NaF PET/CT, Tc-99m MDP, bone metastases.

Abstract

Objective: To study bone scintigraphy using between F-18 NaF PET/CT and Tc-99m MDP scan for detecting bone metastases.

Material and Methods: Thirteen patients (5 males, mean age 55.4 years, range 34-74 years) who were suspected bone metastases with single or two equivocal lesions on Tc-99m MDP bone scan were recruited between October 2010 and October 2012. All these patients underwent F-18 NaF PET/CT scan within one week after Tc-99m MDP bone scan. The sensitivity, specificity and accuracy of Tc-99m MDP bone scan and F-18 NaF PET/CT in differentiating metastatic bone lesion from benign lesion by patientbased and lesion-based analyses were studied.

Results: F-18 NaF PET/CT could identify all seven patients with malignant bone metastases that Tc-99m MDP bone scan was interpreted as malignancy in only three patients (42.9%) and equivocal in the rest of these patients. For lesion-based analysis of the overall 75 lesions, the sensitivity, specificity and accuracy of Tc-99m MDP bone scan were 48%, 83.3% and 70.7% and F-18 NaF PET/CT were 100% for all parameters. Besides the ability of F-18 NaF PET/CT to accurately identify malignancy from benign lesion, unenhanced CT portion of PET/CT can show extra-osseous findings that may change patient management.

Conclusion: F-18 NaF PET/CT provides an excellent bone image quality and higher accuracy than Tc-99m MDP bone scan. Then F-18 NaF PET/CT is a good choice for evaluating bone metastases.

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