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Clinical Trial
. 2010 Dec 15;16(24):6093-9.
doi: 10.1158/1078-0432.CCR-10-1357. Epub 2010 Oct 25.

Prognostic value of baseline [18F] fluorodeoxyglucose positron emission tomography and 99mTc-MDP bone scan in progressing metastatic prostate cancer

Gustavo S P Meirelles  1 , Heiko Schöder, Gregory C Ravizzini, Mithat Gönen, Josef J Fox, John Humm, Michael J Morris, Howard I Scher, Steven M Larson
Affiliations
Clinical Trial

Prognostic value of baseline [18F] fluorodeoxyglucose positron emission tomography and 99mTc-MDP bone scan in progressing metastatic prostate cancer

Gustavo S P Meirelles et al. Clin Cancer Res. .

Abstract

Purpose: To compare the diagnostic and prognostic value of [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET) and bone scans (BS) in the assessment of osseous lesions in patients with progressing prostate cancer.

Experimental design: In a prospective imaging trial, 43 patients underwent FDG-PET and BS prior to experimental therapies. Bone scan index (BSI) and standardized uptake value (SUV) on FDG-PET were recorded. Patients were followed until death (n = 36) or at least 5 years (n = 7). Imaging findings were correlated with survival.

Results: Osseous lesions were detected in 39 patients on BS and 32 on FDG-PET (P = 0.01). Follow-up was available for 105 FDG-positive lesions, and 84 (80%) became positive on subsequent BS. Prognosis correlated inversely with SUV (median survival 14.4 versus 32.8 months if SUVmax > 6.10 versus ≤ 6.10; P = 0.002) and BSI (14.7 versus 28.2 months if BSI > 1.27 versus < 1.27; P = 0.004). Only SUV was an independent factor in multivariate analysis.

Conclusion: This study of progressive prostate cancer confirms earlier work that BSI is a strong prognostic factor. Most FDG-only lesions at baseline become detectable on follow-up BS, suggesting their strong clinical relevance. FDG SUV is an independent prognostic factor and provides complementary prognostic information.

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Conflict of interest statement

Disclosure of Potential Conflicts of Interest: No potential conflicts of interest.

Figures

Figure 1
Figure 1
(A) Negative bone scan, except for foci of degenerative joint disease in the shoulders. (B, C) Coronal and sagittal FDG PET does not show skeletal lesions, but metastatic lymph node (arrows) is identified in the left supraclavicular region.
Figure 1
Figure 1
(A) Negative bone scan, except for foci of degenerative joint disease in the shoulders. (B, C) Coronal and sagittal FDG PET does not show skeletal lesions, but metastatic lymph node (arrows) is identified in the left supraclavicular region.
Figure 1
Figure 1
(A) Negative bone scan, except for foci of degenerative joint disease in the shoulders. (B, C) Coronal and sagittal FDG PET does not show skeletal lesions, but metastatic lymph node (arrows) is identified in the left supraclavicular region.
Figure 2
Figure 2
53 year old male with castrate resistant metastatic prostate cancer. (A) The initial bone scan shows several osseous metastases in the right 5th rib, sternum, left iliac bone and acetabulum. (B) FDG PET scan 4 days later shows the same lesions and in addition 2 metastatic foci in the lumbar spine (arrows). (C) A bone scan 6 months later shows abnormal tracer uptake in these lumbar vertebrae (dotted arrows).
Figure 2
Figure 2
53 year old male with castrate resistant metastatic prostate cancer. (A) The initial bone scan shows several osseous metastases in the right 5th rib, sternum, left iliac bone and acetabulum. (B) FDG PET scan 4 days later shows the same lesions and in addition 2 metastatic foci in the lumbar spine (arrows). (C) A bone scan 6 months later shows abnormal tracer uptake in these lumbar vertebrae (dotted arrows).
Figure 2
Figure 2
53 year old male with castrate resistant metastatic prostate cancer. (A) The initial bone scan shows several osseous metastases in the right 5th rib, sternum, left iliac bone and acetabulum. (B) FDG PET scan 4 days later shows the same lesions and in addition 2 metastatic foci in the lumbar spine (arrows). (C) A bone scan 6 months later shows abnormal tracer uptake in these lumbar vertebrae (dotted arrows).
Figure 3
Figure 3
(A) Kaplan-Meier survival curves: FDG PET SUV: Survival curves for 22 patients with low (≤6.10) and 21 patients with high (>6.10) SUVmax, p=0.002. (B) Kaplan-Meier survival curves: Bone scan index: Survival curves for 22 patients with low (≤ 1.27) and 21 patients with high (>1.27) BSI, p=0.004. (C) Joint analysis of SUVmax and BSI showing two patient groups with distinct prognosis. In the low SUV and low BSI group, median survival is 32.6 months; in the “high” SUV and BSI group, survival was 14.4 months and there is a distinct difference between the curves (p=0.001).
Figure 3
Figure 3
(A) Kaplan-Meier survival curves: FDG PET SUV: Survival curves for 22 patients with low (≤6.10) and 21 patients with high (>6.10) SUVmax, p=0.002. (B) Kaplan-Meier survival curves: Bone scan index: Survival curves for 22 patients with low (≤ 1.27) and 21 patients with high (>1.27) BSI, p=0.004. (C) Joint analysis of SUVmax and BSI showing two patient groups with distinct prognosis. In the low SUV and low BSI group, median survival is 32.6 months; in the “high” SUV and BSI group, survival was 14.4 months and there is a distinct difference between the curves (p=0.001).
Figure 3
Figure 3
(A) Kaplan-Meier survival curves: FDG PET SUV: Survival curves for 22 patients with low (≤6.10) and 21 patients with high (>6.10) SUVmax, p=0.002. (B) Kaplan-Meier survival curves: Bone scan index: Survival curves for 22 patients with low (≤ 1.27) and 21 patients with high (>1.27) BSI, p=0.004. (C) Joint analysis of SUVmax and BSI showing two patient groups with distinct prognosis. In the low SUV and low BSI group, median survival is 32.6 months; in the “high” SUV and BSI group, survival was 14.4 months and there is a distinct difference between the curves (p=0.001).
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References

    1. Scher HI, Sawyers CL. Biology of progressive, castration-resistant prostate cancer: directed therapies targeting the androgen-receptor signaling axis. J Clin Oncol. 2005;23:8253–8261. - PubMed
    1. Soloway MS, Hardeman SW, Hickey D, et al. Stratification of patients with metastatic prostate cancer based on extent of disease on initial bone scan. Cancer. 1988;61:195–202. - PubMed
    1. Yamashita K, Denno K, Ueda T, et al. Prognostic significance of bone metastases in patients with metastatic prostate cancer. Cancer. 1993;71:1297–1302. - PubMed
    1. Imbriaco M, Larson SM, Yeung HW, et al. A new parameter for measuring metastatic bone involvement by prostate cancer: the Bone Scan Index. Clin Cancer Res. 1998;4:1765–1772. - PubMed
    1. Sabbatini P, Larson SM, Kremer A, et al. Prognostic significance of extent of disease in bone in patients with androgen-independent prostate cancer. J Clin Oncol. 1999;17:948–957. - PubMed

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