Combined ^sup 18^F-Fluoride and ^sup 18^F-FDG PET/CT Scanning for Evaluation of Malignancy: Results of an International Multicenter Trial

• Published in: The Journal of nuclear medicine (1978) Vol. 54; no. 2; p. 176
• Main Authors: Iagaru, Andrei, Mittra, Erik, Mosci, Camila, Dick, David W, Sathekge, Mike, Prakash, Vineet, Iyer, Victor, Lapa, Paula, Isidoro, Jorge, de Lima, Joao M, Gambhir, Sanjiv Sam
• Format: Journal Article
• Language: English
• Published: New York Society of Nuclear Medicine 01-02-2013
• Subjects: Cancer; Clinical trials; Glucose; Metabolism; Metastasis
• ISSN: 0161-5505; 1535-5667

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. 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. 18F-/18F-FDG 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 18F-FDG PET/CT was negative. The extent of skeletal lesions was similar in 18 participants on all 3 scans. 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.