Iagaru, Andrei2; Mittra, Erik2; Mosci, Camila2; Dick, David W.2; Sathekge, Mike2; Prakash, Vineet4; Iyer, Victor Vishwanath4; Lapa, Paula2; Isidoro, Jorge2; de Lima, Joao M.2; Gambhir, Sanjiv Sam2
1 Department of Clinical Medicine - Nuklearmedicinsk Afdeling, Aalborg Sygehus, Department of Clinical Medicine, Health, Aarhus University2 unknown3 Department of Clinical Medicine, Health, Aarhus University4 Department of Clinical Medicine, Health, Aarhus University
18F-FDG PET/CT is used in a variety of cancers, but because of variable rates of glucose metabolism, not all cancers are reliably identified. 18F2 PET/CT allows for the acquisition of highly sensitive and specific images of the skeleton. We prospectively evaluated combined 18F2/18F-FDG as a single PET/CT examination for evaluation of cancer patients and compared it with separate 18F2 PET/CT and 18F-FDG PET/CT scans. Methods: One hundred fifteen participants with cancer were prospectively enrolled in an international multicenter trial evaluating 18F2 PET/CT, 18F-FDG PET/CT, and combined 18F2/18F-FDG PET/CT. The 3 PET/CT scans were performed sequentially within 4 wk of one another for each patient. Results: 18F2/18FFDG PET/CT allowed for accurate interpretation of radiotracer uptake outside the skeleton, with findings similar to those of 18F-FDG PET/CT. In 19 participants, skeletal disease was more extensive on 18F2 PET/CT and 18F2/18F-FDG PET/CT than on 18F-FDG PET/CT. In another 29 participants, 18F2 PET/CT and 18F2/18F-FDG PET/CT showed osseous metastases where 18FFDG PET/CT was negative. The extent of skeletal lesions was similar in 18 participants on all 3 scans. Conclusion: This trial demonstrated that combined 18F2/18F-FDG PET/CT shows promising results when compared with separate 18F2 PET/CT and 18F-FDG PET/CT for evaluation of cancer patients. This result opens the possibility for improved patient care and reduction in health-care costs, as will be further evaluated in future trials.