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

This study compared the diagnostic accuracy of 18F-FDG PET/CT with that of 18F-fluoride PET/CT in the detection of bony metastases in heightened-risk head and neck cancer patients. Methods: The study participants underwent 18F-FDG PET/CT and 18F-fluoride PET/CT within 2 wk of each another. Results: A total of 98 bony metastases were found in 18 of our 80 patients. 18F-fluoride PET/CT and 18F-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. Conclusion: 18F-fluoride PET/CT is a feasible modality for detecting bony metastases in patients with head and neck cancers, with similar sensitivity to 18F-FDG PET/CT. Their combined use may not be justifiable.

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