Comparison of FDG PET and SPECT for Detection of Bone Metastases in Breast Cancer
Takayoshi Uematsu1,2,
Sachiko Yuen1,
Seigo Yukisawa1,
Takeshi Aramaki1,
Naoki Morimoto1,
Masahiro Endo1,
Hiroyoshi Furukawa1,
Yoshihiro Uchida2,3 and
Junichiro Watanabe2,4
1 Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital, Nagaizumi,
Shizuoka 411-8777, Japan.
2 Breast Care Unit, Shizuoka Cancer Center Hospital, Shizuoka 411-8777,
Japan.
3 Division of Breast Surgery, Shizuoka Cancer Center Hospital, Shizuoka
411-8777, Japan.
4 Division of Medical Oncology, Shizuoka Cancer Center Hospital, Shizuoka
411-8777, Japan.
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Fig. 1A. —39-year-old woman with true-positive findings on SPECT.
Whole-body planar bone scans show no area of increased uptake of
99mTc hydroxymethylenediphosphonate (HMDP).
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Fig. 1B. —39-year-old woman with true-positive findings on SPECT.
Whole-body planar bone scans show no area of increased uptake of
99mTc hydroxymethylenediphosphonate (HMDP).
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Fig. 1C. —39-year-old woman with true-positive findings on SPECT.
Sagittal FDG PET slice shows no area of increased FDG in axial skeleton.
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Fig. 1D. —39-year-old woman with true-positive findings on SPECT.
Coronal SPECT image shows sternum with increased uptake of 99mTc
HMDP.
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Fig. 1E. —39-year-old woman with true-positive findings on SPECT. Bone
metastasis (arrows) in sternum is present on T1-weighted
contrast-enhanced MR image.
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Fig. 1F. —39-year-old woman with true-positive findings on SPECT. Axial
CT image shows faint osteolytic changes (arrowheads).
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Fig. 2A. —59-year-old woman with false-positive findings on SPECT.
Whole-body planar bone scan shows no area of increased uptake of
99mTc hydroxymethylenediphosphonate (HMDP).
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Fig. 2B. —59-year-old woman with false-positive findings on SPECT.
Sagittal FDG PET image shows no area of increased FDG uptake in axial
skeleton.
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Fig. 2C. —59-year-old woman with false-positive findings on SPECT. Bone
SPECT image through lower neck shows anterior and posterior areas of cervical
vertebral body with increased uptake of 99mTc HMDP.
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Fig. 2D. —59-year-old woman with false-positive findings on SPECT.
Axial CT scan at same level as C shows osteophytes of vertebral body
with no bone metastasis.
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Fig. 3A. —63-year-old woman with osteoblastic bone metastases. Axial CT
image (A), 3D maximum-intensity-projection CT image (B),
sagittal SPECT image (C), and sagittal FDG PET image (D) show
osteoblastic deposits in vertebral bodies have increase in uptake of
99mTc hydroxymethylenediphosphonate (arrows) but not in
uptake of FDG PET. Hypermetabolic lesion in mediastinum (arrowhead)
was confirmed to be lymph node recurrence.
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Fig. 3B. —63-year-old woman with osteoblastic bone metastases. Axial CT
image (A), 3D maximum-intensity-projection CT image (B),
sagittal SPECT image (C), and sagittal FDG PET image (D) show
osteoblastic deposits in vertebral bodies have increase in uptake of
99mTc hydroxymethylenediphosphonate (arrows) but not in
uptake of FDG PET. Hypermetabolic lesion in mediastinum (arrowhead)
was confirmed to be lymph node recurrence.
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Fig. 3C. —63-year-old woman with osteoblastic bone metastases. Axial CT
image (A), 3D maximum-intensity-projection CT image (B),
sagittal SPECT image (C), and sagittal FDG PET image (D) show
osteoblastic deposits in vertebral bodies have increase in uptake of
99mTc hydroxymethylenediphosphonate (arrows) but not in
uptake of FDG PET. Hypermetabolic lesion in mediastinum (arrowhead)
was confirmed to be lymph node recurrence.
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Fig. 3D. —63-year-old woman with osteoblastic bone metastases. Axial CT
image (A), 3D maximum-intensity-projection CT image (B),
sagittal SPECT image (C), and sagittal FDG PET image (D) show
osteoblastic deposits in vertebral bodies have increase in uptake of
99mTc hydroxymethylenediphosphonate (arrows) but not in
uptake of FDG PET. Hypermetabolic lesion in mediastinum (arrowhead)
was confirmed to be lymph node recurrence.
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Fig. 4A. —68-year-old woman with osteolytic bone metastasis. Axial CT
image (A), bone SPECT image (B), and FDG PET image (C)
show osteolytic deposits (arrows) in left ilium have increase in
uptake of FDG PET but not in uptake of 99mTc
hydroxymethylenediphosphonate.
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Fig. 4B. —68-year-old woman with osteolytic bone metastasis. Axial CT
image (A), bone SPECT image (B), and FDG PET image (C)
show osteolytic deposits (arrows) in left ilium have increase in
uptake of FDG PET but not in uptake of 99mTc
hydroxymethylenediphosphonate.
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Fig. 4C. —68-year-old woman with osteolytic bone metastasis. Axial CT
image (A), bone SPECT image (B), and FDG PET image (C)
show osteolytic deposits (arrows) in left ilium have increase in
uptake of FDG PET but not in uptake of 99mTc
hydroxymethylenediphosphonate.
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Fig. 5A. —46-year-old woman with osteoblastic metastasis. Axial CT scan
(A), bone SPECT image (B), and axial FDG PET image (C)
show osteoblastic deposits (arrows) in sacrum have increase in uptake
of 99mTc hydroxymethylenediphosphonate (HMDP) and FDG PET, but
osteoblastic deposits (arrowheads) in right ilium show increase in
uptake of 99mTc HMDP without increase in uptake of FDG PET.
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Fig. 5B. —46-year-old woman with osteoblastic metastasis. Axial CT scan
(A), bone SPECT image (B), and axial FDG PET image (C)
show osteoblastic deposits (arrows) in sacrum have increase in uptake
of 99mTc hydroxymethylenediphosphonate (HMDP) and FDG PET, but
osteoblastic deposits (arrowheads) in right ilium show increase in
uptake of 99mTc HMDP without increase in uptake of FDG PET.
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Fig. 5C. —46-year-old woman with osteoblastic metastasis. Axial CT scan
(A), bone SPECT image (B), and axial FDG PET image (C)
show osteoblastic deposits (arrows) in sacrum have increase in uptake
of 99mTc hydroxymethylenediphosphonate (HMDP) and FDG PET, but
osteoblastic deposits (arrowheads) in right ilium show increase in
uptake of 99mTc HMDP without increase in uptake of FDG PET.
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Fig. 6A. —62-year-old woman with osteolytic metastases. Axial CT scan
(A), bone SPECT image (B), and axial FDG PET image (C)
reveal that osteolytic deposits (arrows) in pelvis show increase in
uptake of 99mTc hydroxymethylenediphosphonate and FDG PET.
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Fig. 6B. —62-year-old woman with osteolytic metastases. Axial CT scan
(A), bone SPECT image (B), and axial FDG PET image (C)
reveal that osteolytic deposits (arrows) in pelvis show increase in
uptake of 99mTc hydroxymethylenediphosphonate and FDG PET.
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Fig. 6C. —62-year-old woman with osteolytic metastases. Axial CT scan
(A), bone SPECT image (B), and axial FDG PET image (C)
reveal that osteolytic deposits (arrows) in pelvis show increase in
uptake of 99mTc hydroxymethylenediphosphonate and FDG PET.
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Copyright © 2005 by the American Roentgen Ray Society.
