Utility of 18F-fluoride PET/CT and 18F-FDG PET/CT in the detection of bony metastases in heightened-risk head and neck cancer patients.

Abstract

This study compared the diagnostic accuracy of (18)F-FDG PET/CT with that of (18)F-fluoride PET/CT in the detection of bony metastases in heightened-risk head and neck cancer patients. The study participants underwent (18)F-FDG PET/CT and (18)F-fluoride PET/CT within 2 wk of each another. A total of 98 bony metastases were found in 18 of our 80 patients. (18)F-fluoride PET/CT and (18)F-FDG PET/CT showed similar lesion-based sensitivity (69.4% vs. 57.1%, P = 0.126) and areas under the curve (0.7561 vs. 0.7959, P = 0.149). Their combined interpretation demonstrated a significantly greater sensitivity and areas under the curve than that obtained with either modality alone (P < 0.001) in lesion-based analysis but not in patient-based analysis, with a treatment strategy change in 2 patients. (18)F-fluoride PET/CT is a feasible modality for detecting bony metastases in patients with head and neck cancers, with similar sensitivity to (18)F-FDG PET/CT. Their combined use may not be justifiable.