Bone Imaging in Oncology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 November 2020) | Viewed by 5906

Special Issue Editor

1. Department of Nuclear Medicine and Clinical Cancer Research Center, Aalborg University Hospital, DK-9000 Aalborg, Denmark
2. Department of Clinical Medicine, Aalborg University, DK-9000 Aalborg, Denmark
Interests: PSMA PET/CT; Prostate cancer; bone metastases; molecular imaging; diagnostic test accuracy-tests; PET/CT
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Special Issue Information

Dear Colleagues

It is well known that bones are one of the frequent sites for metastatic spread from a large number of solid cancer types. Bone metastases are particularly seen in common cancers such as prostate cancer, lung cancer, and breast cancer. The presence of bone metastases alters the treatment strategy at primary staging of patients but also at time of recurrence. Imaging of bone metastases is of paramount importance because the presence of bone metastases changes treatment strategy and prognosis.

The clinical entity oligo-metastatic disease has been extensively debated, and in some cancer types the use of metastases-directed therapy has gained wide acceptance. However, the definition of oligo-metastatic disease is ambiguous and depends upon the diagnostic characteristics of the imaging modality used.

In the past several decades, the use of CT, X-ray, and bone scintigraphy have been dominating the diagnostic armamentarium, but with the technical developments in MRI, e.g., with diffusion weighted images and in PET/CT with FDG and newer specific tracers such as prostate-specific membrane antigen (PSMA) in prostate cancer and fluoroestradiol (FES) in breast cancer, the landscape of imaging has changed. The use of newer imaging modalities holds promise of a more accurate diagnostic accuracy; this has also been documented in several prospective studies. The diagnostic superiority has not (yet) been transferred into improved patient-related outcomes in terms of improved survival or quality of life, but the modern imaging modalities also offer opportunities for quantitative analysis of bone lesions with improved prognostic values.

This Special Issue of “Bone Imaging in Oncology” stipulates an up to date view of the advances made towards the imaging of bone metastases in oncology. It includes all fields within bone metastases and all imaging modalities that can be used in staging, recurrent disease, and for response assessment. Likewise, comparative studies with other biomarkers, health care analyses, and studies regarding improved prognostic values are included too.

Assoc. Prof. Helle D. Zacho
Guest Editor

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Keywords

  • Oncology
  • Bone metastases
  • Imaging
  • Diagnosis
  • Bone scintigraphy
  • MRI
  • CT
  • PET/CT
  • X-ray
  • Ultrasound

Published Papers (2 papers)

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Research

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10 pages, 1019 KiB  
Article
The Value of 68Ga-PSMA PET/CT Following Equivocal 18F-NaF PET/CT in Prostate Cancer Patients
by Claus Madsen, Peter Østergren and Christian Haarmark
Diagnostics 2020, 10(6), 352; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10060352 - 28 May 2020
Cited by 7 | Viewed by 2529
Abstract
Background: Inconclusive bone scans are a challenge but there is no consensus about follow-up imaging. We evaluated the use of 68gallium-labelled prostate-specific membrane antigen (68Ga-PSMA) PET/CT if 18F-sodium fluoride (18F-NaF) PET/CT was inconclusive. Methods: This retrospective study [...] Read more.
Background: Inconclusive bone scans are a challenge but there is no consensus about follow-up imaging. We evaluated the use of 68gallium-labelled prostate-specific membrane antigen (68Ga-PSMA) PET/CT if 18F-sodium fluoride (18F-NaF) PET/CT was inconclusive. Methods: This retrospective study included patients with no previously known bone metastases who had one or more equivocal bone lesions on 18F-NaF PET/CT and underwent additional 68Ga-PSMA PET/CT. The bone lesions were deemed as true metastases or not based on follow-up by surveying supplemental imaging modalities and hospital records. A subgroup of patients with “most valid follow-up” was created, which included patients with unmeasurable PSA after prostatectomy or subsequent imaging (additional 18F-NaF PET/CT, 68Ga-PSMA PET/CT, CT, or MRI). Results: Of the 2918 patients referred for 18F-NaF PET/CT from the department of urology in the inclusion period, 51 (1.7%) were inconclusive regarding bone metastases and underwent additional 68Ga-PSMA PET/CT. Thirteen of these patients (25%) were ultimately diagnosed with bone metastases. Patient-based sensitivity, specificity, and accuracy of additional 68Ga-PSMA PET/CT were 100%, 95%, and 96%, respectively. In patients with “most valid follow-up”, the same parameters were 100%, 93%, and 94%, respectively. Conclusion: 68Ga-PSMA PET/CT is an excellent complementary modality in when 18F-NaF PET/CT is equivocal. Full article
(This article belongs to the Special Issue Bone Imaging in Oncology)
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Review

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12 pages, 1017 KiB  
Review
Nuclear Imaging for Bone Metastases in Prostate Cancer: The Emergence of Modern Techniques Using Novel Radiotracers
by Wietske I. Luining, Dennie Meijer, Max R. Dahele, André N. Vis and Daniela E. Oprea-Lager
Diagnostics 2021, 11(1), 117; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11010117 - 13 Jan 2021
Cited by 7 | Viewed by 2976
Abstract
Accurate staging of prostate cancer (PCa) at initial diagnosis and at biochemical recurrence is important to determine prognosis and the optimal treatment strategy. To date, treatment of metastatic PCa has mostly been based on the results of conventional imaging with abdominopelvic computed tomography [...] Read more.
Accurate staging of prostate cancer (PCa) at initial diagnosis and at biochemical recurrence is important to determine prognosis and the optimal treatment strategy. To date, treatment of metastatic PCa has mostly been based on the results of conventional imaging with abdominopelvic computed tomography (CT) and bone scintigraphy. However, these investigations have limited sensitivity and specificity which impairs their ability to accurately identify and quantify the true extent of active disease. Modern imaging modalities, such as those based on the detection of radioactively labeled tracers with combined positron emission tomography/computed tomography (PET/CT) scanning have been developed specifically for the detection of PCa. Novel radiotracers include 18F-sodium fluoride (NaF), 11C-/18F-fluorocholine (FCH), 18F-fluordihydrotestosterone (FDHT), 68Gallium and 18F-radiolabeled prostate-specific membrane antigen (e.g., 68Ga-PSMA-11, 18F-DCFPyL). PET/CT with these tracers outperforms conventional imaging. As a result of this, although their impact on outcome needs to be better defined in appropriate clinical trials, techniques like prostate-specific membrane antigen (PSMA) PET/CT have been rapidly adopted into clinical practice for (re)staging PCa. This review focuses on nuclear imaging for PCa bone metastases, summarizing the literature on conventional imaging (focusing on CT and bone scintigraphy—magnetic resonance imaging is not addressed in this review), highlighting the prognostic importance of high and low volume metastatic disease which serves as a driver for the development of better imaging techniques, and finally discussing modern nuclear imaging with novel radiotracers. Full article
(This article belongs to the Special Issue Bone Imaging in Oncology)
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