18F sodium fluoride PET/CT detects osseous metastases from breast cancer missed on FDG PET/CT with marrow rebound

Clin Nucl Med. 2013 Sep;38(9):746-8. doi: 10.1097/RLU.0b013e3182996138.

Abstract

Intense FDG uptake by bone marrow following recent chemotherapy limits evaluation for osseous metastases. The impact of marrow rebound on accuracy of (18)F-fluoride PET/CT is unclear. A 73-year-old woman with breast cancer presented for restaging FDG PET/CT, which showed intense activity throughout almost the entire axial skeleton and no osseous metastases. An (18)F-fluoride PET/CT performed 7 days later identified multiple osseous metastases in the spine, ribs, and pelvis. This case demonstrates that (18)F-fluoride PET/CT should be considered for the evaluation of osseous metastases in patients with rebound marrow uptake on FDG PET/CT.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / secondary
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Female
  • Fluorine Radioisotopes*
  • Fluorodeoxyglucose F18*
  • Humans
  • Osteoblasts / pathology
  • Positron-Emission Tomography*
  • Sodium Fluoride*
  • Tomography, X-Ray Computed*
  • Whole Body Imaging

Substances

  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Sodium Fluoride