Bone SPECT Superior to FDG PET for Detecting Bone Metastases in Breast Cancer

Bone SPECT is better than FDG PET for detecting breast cancer that has spread (metastasized) to a patient’s bones, according to researchers from Shizuoka Cancer Center Hospital in Japan.

FDG PET is an imaging technique based on the increased metabolism of glucose in tumor cells. SPECT is a type of nuclear medicine scan that detects special radioactive elements administered to the patient by the physician. According to the authors, due to these differences in method, bone SPECT images can reveal the location of bone metastases, whereas PET cannot. In addition, bone SPECT can detect where bone is being regenerated after destruction by tumor cells.

For the study, the researchers analyzed the findings in a total of 900 bones in 15 patients with breast cancer who underwent both SPECT and PET. They found that SPECT had a sensitivity of 85% and an accuracy of 96% for detecting bone metastases, whereas PET had a sensitivity of only 17% and an accuracy of 85%. They also found that PET was limited in its ability to reveal certain types of cancer lesions.

“Bone is the most common site of breast cancer metastasis. Up to 90% of patients dying with distant breast cancer have bone metastases. Bone is also the most frequent recurrence site after treatment for primary breast cancer,” said Takayoshi Uematsu, MD, lead author of the study.

Figuring out which imaging method is the best for a particular disease is crucial in patient treatment, say the study authors. “Early diagnosis and treatment of bone metastases might improve outcomes in breast cancer patients, and the appropriate imaging method is able to assist in the early detection of bone metastases,” said Dr. Uematsu.

The study appears in the April 2005 issue of the American Journal of Roentgenology.