May 17 – 20, 2015
La Biodola, Isola d'Elba
Europe/Rome timezone

Imaging Patients with Breast and Prostate Cancers Using Combined 18F NaF/18F FDG and TOF simultaneous PET/ MRI

May 20, 2015, 8:50 AM
Room Maria Luisa

Room Maria Luisa

Talk 7 - Clinical MR-PET Session 10 - Clinical MR-PET


Andrei Iagaru (Stanford University)


Introduction: Here we prospectively compared the combined 18F NaF/18F FDG PET/ MRI against 99mTc-MDP in patients with breast and prostate cancers. Methods: Twelve patients referred for 99mTc-MDP bone scans were prospectively enrolled from Oct 14 - Jan 15. The cohort included 6 men with prostate cancer and 6 women with breast cancer, 41 – 85 year-old (average 63 ± 15). 18F NaF (0.7-2.2 mCi, mean: 1.33 mCi) and 18F FDG (3.9-5.2 mCi, mean: 4.6 mCi) were subsequently injected from separate syringes. The PET/MRI was done 6-12 days (average 9.3 ± 3.2) after bone scan. The whole body MRI protocol consisted of T2-weighted, DWI, and contrast-enhanced T1-weighted imaging. Lesions detected with each test were tabulated and the results were compared. Results: All patients tolerated the PET/MRI exam, and PET image quality was diagnostic despite the marked reduction in the administered dosage of radiopharmaceuticals (80% less for 18F NaF and 67% less for 18F FDG). Five patients had no bone metastases identified on either scans. Bone scintigraphy and PET/MRI showed osseous metastases in 7 patients, but more numerous bone findings were noted on PET/MRI than on bone scintigraphy in 3 patients. Lesions outside the skeleton were identified by PET/MRI in 2 patients. Conclusion: The combined 18F NaF/18F FDG PET/MRI is superior to 99mTc-MDP scintigraphy for evaluation of skeletal disease extent. Further, it detected extra-skeletal disease that may change the management of these patients, while allowing a significant reduction in radiation exposure from lower dosages of PET radiopharmaceuticals administered. A combination of 18F NaF/18F FDG PET/MRI may provide the most accurate staging of patients with breast and prostate cancers prior to the start of treatment.

Primary author

Andrei Iagaru (Stanford University)


Amir Barkhodari (Stanford University) Mehran Jamali (Stanford University) Ryogo Minamimoto (Stanford University) Sanjiv Gambhir (Stanford University) Shreyas Vasanawala (Stanford University)

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