Impact of F-18-fluoride PET-CT on implementing early treatment of painful bone metastases with Sm-153 EDTMP(346 views)(PDF public10 views) Storto G, Gallicchio R, Pellegrino T, Nardelli A, Capacchione D, Sirignano C, Pace L
Keywords: 18f-Fluoride Pet Ct, Bone Scan, Early Bone Pain, Radionuclide Therapy, Sm-153 Edtmp, Bisphosphonic Acid Derivative, Contrast Medium, Etidronic Acid Tc 99m, Fluorine 18, Lexidronam Samarium Sm 153, Nonsteroid Antiinflammatory Agent, Zoledronic Acid, Diagnostic Agent, Organometallic Compound, Organophosphorus Compound, Samarium Ethylenediaminetetramethylenephosphonate, Article, Bone Metastasis, Bone Scintiscanning, Cancer Palliative Therapy, Cancer Radiotherapy, Clinical Article, Computer Assisted Emission Tomography, Controlled Study, Early Intervention, Human, Prostate Cancer, Randomized Controlled Trial, Visual Analog Scale, Bone Tumor, Multimodal Imaging, Pain Assessment, Pathology, Prostate Tumor, Bone Neoplasms, Fluorine Radioisotopes, Pain Measurement, Palliative Care, Prostatic Neoplasms, Time Factors, Bone Neoplasms Complications Secondary, Fluorides Diagnostic Use, Fluorine Radioisotopes Diagnostic Use, Organometallic Compounds Therapeutic Use, Organophosphorus Compounds Therapeutic Use, Pain Complications Radionuclide Imaging Radiotherapy, Prostatic Neoplasms Pathology,
Affiliations: *** IBB - CNR ***
IRCCS, CROB, Rionero in Vulture, Italy
Institute of Biostructure and Bioimages, National Council of Research, Naples, Italy
Diagnostica per Immagini e Radioterapia, Università di Salerno, Salerno, Italy
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Impact of F-18-fluoride PET-CT on implementing early treatment of painful bone metastases with Sm-153 EDTMP
This study evaluated the diagnostic impact of using skeletal F-18-fluoride PET/CT on patients with painful bone metastases to schedule an early palliative radionuclide treatment. Methods: The skeletal involvement from prostate cancer metastases was assessed by both Tc-99m-diphosphonate bone scan (BS) and F-18-fluoride PET/CT within four weeks in 24 patients (67.7 +/- 5.1 years) suffering from a borderline degree of bone pain for which radionuclide palliation was not shortly planned for administration. The BS and F-18-fluoride PET/CT results were compared, assessing the number and extension of the skeletal sites involved. Afterward, the patients were randomly assigned either to the study group (N = 12) receiving radionuclide therapy (Samarium-153 EDTMP) or to the control group (N = 12) not receiving radionuclide therapy. The short-term results from the radionuclide palliation group (evaluated with a visual analogue scale) were compared with the controls. Results: Overall, at BS, 7.6 +/- 1.4 sites were considered metastatic, involving at least 5 +/- 1 body regions. At F-18-fluoride PET/CT, 116 +/- 19 sites presented metastatic involvement with 12/12 body regions concerned. No differences were found in regards to either the number of metastatic sites or regions at both BS and F-18-fluoride PET/CT between the study group and controls (p = ns). At CT, 88 blastic metastases were identified, whereas 110 were mainly lytic. Most of mainly lytic lesions were not detectable at BS. The reduction in total discomfort and bone pain in the study group was significantly greater than in the controls (p < 0.0001). Conclusion: Sm-153 EDTMP therapy should be considered for patients with early bone pain from prostate cancer even if their BS only indicates a few metastases before the initiation of a severe pain syndrome. F-18-fluoride PET/CT may be helpful in deciding if the implementation of bone pain palliation using bone-seeking radionuclides at pain onset is necessary. (C) 2013 Elsevier Inc. All rights reserved.
Impact of F-18-fluoride PET-CT on implementing early treatment of painful bone metastases with Sm-153 EDTMP
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Impact of F-18-fluoride PET-CT on implementing early treatment of painful bone metastases with Sm-153 EDTMP