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Hansen JA, Naghavi-Behzad M, Gerke O, Baun C, Falch K, Duvnjak S, Alavi A, Høilund-Carlsen PF, Hildebrandt MG. Diagnosis of bone metastases in breast cancer: Lesion-based sensitivity of dual-time-point FDG-PET/CT compared to low-dose CT and bone scintigraphy. PLoS One 2021; 16:e0260066. [PMID: 34793550 PMCID: PMC8601566 DOI: 10.1371/journal.pone.0260066] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 11/02/2021] [Indexed: 11/18/2022] Open
Abstract
We compared lesion-based sensitivity of dual-time-point FDG-PET/CT, bone scintigraphy (BS), and low-dose CT (LDCT) for detection of various types of bone metastases in patients with metastatic breast cancer. Prospectively, we included 18 patients with recurrent breast cancer who underwent dual-time-point FDG-PET/CT with LDCT and BS within a median time interval of three days. A total of 488 bone lesions were detected on any of the modalities and were categorized by the LDCT into osteolytic, osteosclerotic, mixed morphologic, and CT-negative lesions. Lesion-based sensitivity was 98.2% (95.4-99.3) and 98.8% (96.8-99.5) for early and delayed FDG-PET/CT, respectively, compared with 79.9% (51.1-93.8) for LDCT, 76.0% (36.3-94.6) for BS, and 98.6% (95.4-99.6) for the combined BS+LDCT. BS detected only 51.2% of osteolytic lesions which was significantly lower than other metastatic types. SUVs were significantly higher for all lesion types on delayed scans than on early scans (P<0.0001). Osteolytic and mixed-type lesions had higher SUVs than osteosclerotic and CT-negative metastases at both time-points. FDG-PET/CT had significantly higher lesion-based sensitivity than LDCT and BS, while a combination of the two yielded sensitivity comparable to that of FDG-PET/CT. Therefore, FDG-PET/CT could be considered as a sensitive one-stop-shop in case of clinical suspicion of bone metastases in breast cancer patients.
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Affiliation(s)
- Jeanette Ansholm Hansen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Mohammad Naghavi-Behzad
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- * E-mail:
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Christina Baun
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Kirsten Falch
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sandra Duvnjak
- Radiology Department–Breast Imaging, Herlev Gentofte Hospital, Copenhagen, Denmark
- Mammography Screening Center in the Capital Region, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Abass Alavi
- Division of Nuclear Medicine, Department of Radiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States of America
| | - Poul Flemming Høilund-Carlsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Malene Grubbe Hildebrandt
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, Odense, Denmark
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Nadar RA, Farbod K, der Schilden KC, Schlatt L, Crone B, Asokan N, Curci A, Brand M, Bornhaeuser M, Iafisco M, Margiotta N, Karst U, Heskamp S, Boerman OC, van den Beucken JJJP, Leeuwenburgh SCG. Targeting of radioactive platinum-bisphosphonate anticancer drugs to bone of high metabolic activity. Sci Rep 2020; 10:5889. [PMID: 32246003 DOI: 10.1038/s41598-020-62039-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/06/2020] [Indexed: 11/08/2022] Open
Abstract
Platinum-based chemotherapeutics exhibit excellent antitumor properties. However, these drugs cause severe side effects including toxicity, drug resistance, and lack of tumor selectivity. Tumor-targeted drug delivery has demonstrated great potential to overcome these drawbacks. Herein, we aimed to design radioactive bisphosphonate-functionalized platinum (195mPt-BP) complexes to confirm preferential accumulation of these Pt-based drugs in metabolically active bone. In vitro NMR studies revealed that release of Pt from Pt BP complexes increased with decreasing pH. Upon systemic administration to mice, Pt-BP exhibited a 4.5-fold higher affinity to bone compared to platinum complexes lacking the bone-seeking bisphosphonate moiety. These Pt-BP complexes formed less Pt-DNA adducts compared to bisphosphonate-free platinum complexes, indicating that in vivo release of Pt from Pt-BP complexes proceeded relatively slow. Subsequently, radioactive 195mPt-BP complexes were synthesized using 195mPt(NO3)2(en) as precursor and injected intravenously into mice. Specific accumulation of 195mPt-BP was observed at skeletal sites with high metabolic activity using micro-SPECT/CT imaging. Furthermore, laser ablation-ICP-MS imaging of proximal tibia sections confirmed that 195mPt BP co-localized with calcium in the trabeculae of mice tibia.
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Çelebi F. What is the Diagnostic Performance of 18F-FDG-PET/MRI in the Detection of Bone Metastasis in Patients with Breast Cancer? Eur J Breast Health 2019; 15:213-216. [PMID: 31620678 DOI: 10.5152/ejbh.2019.4885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 08/16/2019] [Indexed: 01/27/2023]
Abstract
Objective To evaluate the diagnostic performance of 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/magnetic resonance imaging (MRI) in the detection of bone metastasis in patients with breast cancer. Materials and methods From August 2018 to January 2019, a total of 23 patients with pathologically confirmed invasive breast cancer underwent whole-body hybrid 18F-FDG -PET/MRI for initial staging and follow-up of their malignancies. The number of the bone metastasis was recorded for each patient. The total 18F-FDG-PET/MRI protocol was compared with PET only and the contrast enhanced fused (CE) component for the detection of bone metastasis. Results Eight (26%) of 23 patients had bone metastasis. Bone metastases were dominantly localized in the spine (63%) and pelvis (25%). In terms of the total number of detected bone metastasis, there was a statistically significant difference between 18F-FDG-PET/MRI (mean 3.57; median 0; range, 0-2) and PET only component (mean 2.87; median 0; range, 0-1) (p=0.026), but no statistically significant difference was detected between 18F-FDG-PET/MRI and whole-body CE MRI (mean 3.43; median 0; range 0-2) (p=0.083). Conclusion Whole-body hybrid 18F-FDG-PET/MRI is superior to PET component only, but no statistically significant difference between hybrid 18F-FDG-PET/MRI and whole-body CE MRI is found for the detection of bone metastasis in patients with breast cancer.
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Affiliation(s)
- Filiz Çelebi
- Department of Radiology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
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Affiliation(s)
- Poul Flemming Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Søren Hess
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Radiology and Nuclear Medicine, Hospital of Southwest Jutland, Esbjerg, Denmark
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
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Lindgren Belal S, Sadik M, Kaboteh R, Hasani N, Enqvist O, Svärm L, Kahl F, Simonsen J, Poulsen MH, Ohlsson M, Høilund-Carlsen PF, Edenbrandt L, Trägårdh E. 3D skeletal uptake of 18F sodium fluoride in PET/CT images is associated with overall survival in patients with prostate cancer. EJNMMI Res 2017; 7:15. [PMID: 28210997 PMCID: PMC5313492 DOI: 10.1186/s13550-017-0264-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/07/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Sodium fluoride (NaF) positron emission tomography combined with computer tomography (PET/CT) has shown to be more sensitive than the whole-body bone scan in the detection of skeletal uptake due to metastases in prostate cancer. We aimed to calculate a 3D index for NaF PET/CT and investigate its correlation to the bone scan index (BSI) and overall survival (OS) in a group of patients with prostate cancer. METHODS NaF PET/CT and bone scans were studied in 48 patients with prostate cancer. Automated segmentation of the thoracic and lumbar spines, sacrum, pelvis, ribs, scapulae, clavicles, and sternum were made in the CT images. Hotspots in the PET images were selected using both a manual and an automated method. The volume of each hotspot localized in the skeleton in the corresponding CT image was calculated. Two PET/CT indices, based on manual (manual PET index) and automatic segmenting using a threshold of SUV 15 (automated PET15 index), were calculated by dividing the sum of all hotspot volumes with the volume of all segmented bones. BSI values were obtained using a software for automated calculations. RESULTS BSI, manual PET index, and automated PET15 index were all significantly associated with OS and concordance indices were 0.68, 0.69, and 0.70, respectively. The median BSI was 0.39 and patients with a BSI >0.39 had a significantly shorter median survival time than patients with a BSI <0.39 (2.3 years vs not reached after 5 years of follow-up [p = 0.01]). The median manual PET index was 0.53 and patients with a manual PET index >0.53 had a significantly shorter median survival time than patients with a manual PET index <0.53 (2.5 years vs not reached after 5 years of follow-up [p < 0.001]). The median automated PET15 index was 0.11 and patients with an automated PET15 index >0.11 had a significantly shorter median survival time than patients with an automated PET15 index <0.11 (2.3 years vs not reached after 5 years of follow-up [p < 0.001]). CONCLUSIONS PET/CT indices based on NaF PET/CT are correlated to BSI and significantly associated with overall survival in patients with prostate cancer.
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Affiliation(s)
| | - May Sadik
- Department of Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Reza Kaboteh
- Department of Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Nezar Hasani
- Department of Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Olof Enqvist
- Department of Signals and Systems, Chalmers University of Technology, Göteborg, Sweden
| | | | - Fredrik Kahl
- Department of Signals and Systems, Chalmers University of Technology, Göteborg, Sweden
| | - Jane Simonsen
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Mads H Poulsen
- Department of Urology, Odense University Hospital, Odense, Denmark
| | - Mattias Ohlsson
- Department of Astronomy and Theoretical Physics, Lund University, Lund, Sweden
| | | | - Lars Edenbrandt
- Department of Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Elin Trägårdh
- Department of Translational Medicine, Lund University, Malmö, Sweden
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Riedl CC, Pinker K, Ulaner GA, Ong LT, Baltzer P, Jochelson MS, McArthur HL, Gönen M, Dickler M, Weber WA. Comparison of FDG-PET/CT and contrast-enhanced CT for monitoring therapy response in patients with metastatic breast cancer. Eur J Nucl Med Mol Imaging 2017; 44:1428-37. [PMID: 28462446 DOI: 10.1007/s00259-017-3703-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/09/2017] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this study was to compare fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and contrast-enhanced computed tomography (CE-CT) for the prediction of progression-free survival (PFS) and disease-specific survival (DSS) in patients with stage IV breast cancer undergoing systemic therapy. METHODS Sixty-five patients with metastatic breast cancer treated with first- or second-line systemic therapy in prospective clinical trials were included. Response to treatment was evaluated by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 for CE-CT and by PET Response Criteria in Solid Tumors (PERCIST), respectively. RESULTS All responders by RECIST (n = 22) were also responders by PERCIST, but 40% (17/43) of non-responders by RECIST were responders by PERCIST. Responses according to RECIST and PERCIST both correlated with PFS, but PERCIST showed a significantly higher predictive accuracy (concordance index for PFS: 0.70 vs. 0.60). One-year PFS for responders vs. non-responders by RECIST was 59% vs. 27%, compared to 63% vs. 0% by PERCIST. Four-year DSS of responders and non-responders by RECIST was 50% and 38%, respectively (p = 0.2, concordance index: 0.55) as compared to 58% vs. 18% for PERCIST (p < 0.001, concordance index: 0.65). Response on PET/CT was also a significantly better predictor for DSS than disease control on CE-CT. CONCLUSIONS In patients with metastatic breast cancer, tumor response on PET/CT appears to be a superior predictor of PFS and DSS than response on CE-CT. Monitoring tumor response by PET/CT may increase the power of clinical trials using tumor response as an endpoint, and may improve patient management in clinical routine.
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Simanek M, Koranda P. SPECT/CT imaging in breast cancer - current status and challenges. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2016; 160:474-483. [DOI: 10.5507/bp.2016.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/28/2016] [Indexed: 12/18/2022] Open
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Abstract
Review current treatments of metastatic lesions in the proximal femur.We reviewed published literature related to diagnosis and surgical treatments and summarized current treatment options.Surgical management mainly consist of internal fixation, hip replacement, and percutaneous femoroplasty (PFP) which has been newly applied in clinical practice.An appropriate series of treatments is necessary for patients to avoid the occurrence of paraplegia and prolong survival time.
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Affiliation(s)
- Helin Feng
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University
| | - Jin Wang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University
| | - Jianfa Xu
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University
| | - Wei Chen
- Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yingze Zhang
- Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Correspondence: Yingze Zhang, The Third Hospital of Hebei Medical University, Shijiazhuang, China (e-mail: )
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