NaF PET/CT for Response Assessment of Prostate Cancer Bone Metastases Treated with Single Fraction Stereotactic Ablative Body Radiotherapy

Overview

Journal Radiat Oncol

Publisher Biomed Central

Specialties Oncology
Radiology

Date 2019 Sep 7

PMID 31488175

Citations 5

Authors

Nicholas Hardcastle

Michael S Hofman

Ching-Yu Lee

Jason Callahan

Lisa Selbie

Farshad Foroudi

Mark Shaw

Sarat Chander

Andrew Lim

Brent Chesson

Declan G Murphy

Tomas Kron

Shankar Siva

Affiliations

Soon will be listed here.

Abstract

Introduction: In prostate cancer patients, imaging of bone metastases is enhanced through the use of sodium fluoride positron emission tomography (F-NaF PET/CT). This imaging technique shows areas of enhanced osteoblastic activity and blood flow. In this work, F-NaF PET/CT was investigated for response assessment to single fraction stereotactic ablative body radiotherapy (SABR) to bone metastases in prostate cancer patients.

Methods: Patients with bone metastases in a prospective trial treated with single fraction SABR received a F-NaF PET/CT scan prior to and 6 months post-SABR. The SUV in the tumour was determined and the difference between before and after SABR determined. The change in uptake in the non-tumour bone was also measured as a function of the received SABR dose.

Results: Reduction in SUV was observed in 29 of 33 lesions 6 months after SABR (mean absolute decrease in SUV 17.7, 95% CI 25.8 to - 9.4, p = 0.0001). Of the three lesions with increased SUV post-SABR, two were from the same patient and located in the vertebral column. Both were determined to be local progression in addition to one fracture. The third lesion (in a rib) was shown to be controlled locally but suffered from a fracture at 24 months. Progression adjacent to the treated volume was observed in two patients. The non-tumour bone irradiated showed increased loss in uptake with increasing dose, with a median loss in uptake of 23.3% for bone receiving 24 Gy.

Conclusion: F-NaF PET/CT for response assessment of bone metastases to single fraction SABR indicates high rates of reduction of osteoblastic activity in the tumour and non-tumour bone receiving high doses. The occurrence of marginal recurrence indicates use of larger clinical target volumes may be warranted in treatment of bone metastases.

Trial Registration: POPSTAR, 'Pilot Study of patients with Oligometastases from Prostate cancer treated with STereotactic Ablative Radiotherapy', Universal Trial Number U1111-1140-7563 , Registered 17th April 2013.

Citing Articles

[F]NaF PET/CT imaging of response to single fraction SABR to bone metastases from breast cancer.

Hardcastle N, Liu Y, Siva S, David S Front Nucl Med. 2024; 3:1197397.

PMID: 39380960 PMC: 11460292. DOI: 10.3389/fnume.2023.1197397.

Nuclear medicine imaging for bone metastases assessment: what else besides bone scintigraphy in the era of personalized medicine?.

Ouvrard E, Kaseb A, Poterszman N, Porot C, Somme F, Imperiale A Front Med (Lausanne). 2024; 10:1320574.

PMID: 38288299 PMC: 10823373. DOI: 10.3389/fmed.2023.1320574.

Predicting Fractures Using Vertebral 18F-NaF Uptake in Prostate Cancer Patients.

Chesnais H, Bastin N, Miguez S, Kargilis D, Kalluri A, Terry A J Bone Metab. 2023; 30(4):329-337.

PMID: 38073266 PMC: 10721380. DOI: 10.11005/jbm.2023.30.4.329.

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Corradini S, Niyazi M, Verellen D, Valentini V, Walsh S, Grosu A Radiat Oncol. 2021; 16(1):27.

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Recent updates and developments in PET imaging of prostate cancer.

Rowe S, Johnson G, Pomper M, Gorin M, Behr S Abdom Radiol (NY). 2020; 45(12):4063-4072.

PMID: 32417934 DOI: 10.1007/s00261-020-02570-y.

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