The value of quantitative analysis in ¹⁸F-NaF PET/CT

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Distinguishing bone metastases from degenerative lesions is crucial in cancer staging.
• Differentiating blastic from lytic bone metastases aids treatment planning.
• Standardized uptake value maximum (SUVmax) is a quantitative imaging biomarker.

Purpose of the Study:

• To assess SUVmax's capability in differentiating bone metastases from degenerative lesions.
• To evaluate SUVmax's ability to distinguish blastic from lytic bone metastases.
• To correlate SUVmax values between 18F-NaF and 18F-FDG PET/CT.

Main Methods:

• Retrospective analysis of 115 18F-NaF PET/CT studies.
• Included 49 patients with confirmed bone metastases and 43 with paired 18F-FDG PET/CT data.
• Recorded SUVmax for metastases and degenerative lesions on 18F-NaF PET/CT and for metastases on 18F-FDG PET/CT.

Main Results:

• Mean SUVmax was significantly higher for metastases (26.8±17.3) than degenerative lesions (15.3±6.3) (P<0.001).
• Mean SUVmax was higher for blastic (27.9±18.3) than lytic metastases (22.1±11.3) on 18F-NaF (P=0.03).
• SUVmax above 42 indicated metastases; above 49 indicated blastic metastases, with predictive value (AUC=0.723).

Conclusions:

• SUVmax derived from 18F-NaF PET/CT aids in differentiating bone metastases from degenerative lesions.
• SUVmax can differentiate between blastic and lytic bone metastases.
• SUVmax shows differential correlations with 18F-NaF and 18F-FDG in blastic vs. lytic metastases.