The Case for 18F-NaF PET/CT Bone Metastases Detection

Results from the MITNEC-A1 trial are in, and they further support using 18F-NaF PET/CT to detect bone metastases in patients with prostate and breast cancer, while bolstering its case for replacing 99mTc-MDP as the “bone imaging radiopharmaceutical of choice.”

The prospective, multicenter, single-cohort, phase 3 trial enrolled 261 breast and prostate cancer patients (57 & 204) who had high risk or suspected bone metastasis, scanning each participant with 18F-NaF PET/CT and 99mTc-MDP SPECT. 

Two experts interpreted the scans, which were later compared to 24-month follow-up results, revealing that 42% of the patients had bone metastases (109), and finding that 18F-NaF PET/CT diagnosed bone metastases with far higher…

  • Accuracy – 84.3% vs. 77.4%
  • Sensitivity – 78.9% vs. 63.3%
  • Negative Predictive Value – 85.4% vs. 76.9%

The MITNEC-A1 trial stands on the shoulders of a growing list of studies that support 18F-NaF PET/CT for bone metastases detection, and these latest results make the transition to 18F-NaF PET/CT “appealing” to this study’s authors. 

The next step in that transition process will likely be exploring 18F-NaF PET/CT’s cost-effectiveness versus bone scintigraphy with 99mTc-MDP SPECT, potentially leading to more widespread adoption.

The Takeaway

It’s historically been a challenge to detect prostate and breast cancer bone metastases. Although there’s more research to be done, it appears that 18F-NaF PET/CT might help overcome that challenge, and become bone imaging’s new radiopharmaceutical of choice.

Get every issue of The Imaging Wire, delivered right to your inbox.

You might also like..

Select All

You're signed up!

It's great to have you as a reader. Check your inbox for a welcome email.

-- The Imaging Wire team

You're all set!