Comparative Study of 18-F Sodium Fluoride PET/CT and Bone Scan in Determining Bone Lesions in Newly Diagnosed Prostate Cancer Patient

Muhammad Usman  Ibrahim; FidaHussain; Muhammad Adil; Zaigham Salim Dar; Muhammad Atif; Muhammad Imran Ibrahim

doi:10.51253/pafmj.v74i4.10092

Authors

Muhammad Usman Ibrahim Department of Medicine, Armed Forces Institute of Pathology, Combined Military Hospital/National University of Medical Sciences (NUMS)
FidaHussain Department of Medicine, Armed Forces Institute of Pathology, Combined Military Hospital/National University of Medical Sciences (NUMS)
Muhammad Adil Department of Medicine, Armed Forces Institute of Pathology, Combined Military Hospital/National University of Medical Sciences (NUMS)
Zaigham Salim Dar Department of Medicine, Armed Forces Institute of Pathology, Combined Military Hospital/National University of Medical Sciences (NUMS)
Muhammad Atif Department of Medicine, Armed Forces Institute of Pathology, Combined Military Hospital/National University of Medical Sciences (NUMS)
Muhammad Imran Ibrahim Department of Radiology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i4.10092

Keywords:

Bone scintigraphy, Prostate cancer, Radionuclide imaging, 18F-NaF-PET/CT

Abstract

Objective: To compare the diagnostic performance of bone scintigraphy and 18F-NaF-PET/CT in detection of bone metastasis in newly diagnosed high-grade prostate cancer patients.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology and Armed Forces Institute of Radiology and Imaging, Rawalpindi Pakistan, from Jul 2020 to Dec 2022.

Methodology: Newly diagnosed high-grade prostate cancer patients with Gleason score ≥8 who underwent bone scintigraphy followed by 18F-NaF-PET/CT (Sodium Fluoride-Positron Emission Tomography/Computerized Tomography) for staging during study duration were included. We compared the diagnostic accuracy of both imaging modalities in detecting bone metastasis using two-point scale scoring system i.e., metastasis present or not present on per patient basis.

Results: A total of 45 patients with mean age 69.66±9.38 years and mean Prostatic Surface Antigen level 36.21±65.07 ng/ml were included. 18F-NaF-PET/CT detected bone metastasis in all 25 patients with bone metastasis (100%) compared to 20(80%) by bone scan. 4 patients had false-positive bone scan while 2 had false-positive 18F-NaF-PET/CT scan. Overall 18F-NaF-PET/CT demonstrated a higher sensitivity, specificity, positive predictive value, negative predictive value and accuracy compared to bone scan (100% vs 80%, 90% vs 80%, 92.59% vs 83.33%, 100% vs 76.19%, 95.56% vs 80% respectively).

Conclusion: 18F-NaF-PET/CT has better diagnostic performance than bone scintigraphy for the detection of bone metastasis in newly diagnosed high-grade prostate cancer patients.

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