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.