18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is accurate for high-grade prostate cancer bone staging when compared to bone scintigraphy

Authors

  • Samuel Otis-Chapados
  • Cassandra Ringuette Goulet
  • Gabriel Dubois
  • Étienne Lavallée
  • Thierry Dujardin
  • Yves Fradet
  • Louis Lacombe
  • Michele Lodde
  • Rabi Tiguert
  • Paul Toren
  • Vincent Fradet
  • Jean-Mathieu Beauregard
  • François-Alexandre Buteau
  • Frédéric Pouliot

DOI:

https://doi.org/10.5489/cuaj.7107

Keywords:

Prostate cancer, 18F-FDG-PET/CT, Bone metastasis, Bone scintigraphy

Abstract

Introduction: In this study, we compared 18F-fluorodeoxyglucose (18F-FDG)-positron emission tomography/computed tomography (PET/CT) and bone scintigraphy accuracies for the detection of bone metastases for primary staging in high-grade prostate cancer (PCa) patients to determine if 18F-FDG-PET/CT could be used alone as a staging modality.

Methods: Men with localized high-grade PCa (n=256, Gleason 8–10, International Society of Urological Pathology [ISUP] grades 4 or 5) were imaged with bone scintigraphy and 18F-FDG-PET/ CT. We compared, on a per-patient basis, the accuracy of the two imaging modalities, taking inter-modality agreement as the standard of truth (SOT).

Results: 18F-FDG-PET/CT detected at least one bone metastasis in 33 patients compared to only 26 with bone scan. Of the seven false-negative bone scintigraphies, four (57.1%) were solitary metastases (monometastatic), three (42.9%) were oligometastatic (2–4 lesions), and none were plurimetastatic (>4 lesions). Compared to SOT, 18F-FDG-PET/CT showed higher sensitivity and accuracy than bone scintigraphy (100% vs. 78.8%, and 98.7% vs. 98.2%) for the detection of skeletal lesions.

Conclusions: 18F-FDG-PET/CT appears similar or better than conventional bone scans to assess for bone metastases in patients newly diagnosed with high-grade PCa. Since intraprostatic FDG uptake is also a biomarker for failure of radical prostatectomy and that FDG-PET/CT has been shown to be accurate in detecting PCa lymph node metastasis, FDG-PET/CT has the potential to be used as the sole preoperative staging modality in high-grade PCa.

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Published

2021-03-18

How to Cite

Otis-Chapados, S. ., Ringuette Goulet, C. ., Dubois, G. ., Lavallée, Étienne ., Dujardin, T. ., Fradet, Y. ., Lacombe, L. ., Lodde, M. ., Tiguert, R. ., Toren, P. ., Fradet, V. ., Beauregard, J.-M. ., Buteau, F.-A. ., & Pouliot, F. . (2021). 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is accurate for high-grade prostate cancer bone staging when compared to bone scintigraphy. Canadian Urological Association Journal, 15(10), 301–7. https://doi.org/10.5489/cuaj.7107

Issue

Vol. 15 No. 10 (2021): CUAJ October

Section

Original Research

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