Sodium fluoride (Na-F-18) PET/CT can accurately detect bone metastases in patients with advanced prostate cancer, according to a new pilot study published in The Journal of Nuclear Medicine. Follow-up scans revealed that it's also associated with better clinical outcomes and patient survival.

The American Cancer Society estimates that there will be about 180,890 new cases of prostate cancer and about 26,120 deaths from the disease in the U.S. this year.

The researchers had 30 prostate cancer patients with, and 30 without known bone metastases, using conventional imaging, undergo Na-F-18 PET/CT exams at a 6-month and then 20-month interval.

They then correlated standardized uptake values (SUV) and the amount of lesions with changes in prostate-specific antigen (PSA) levels, clinical impression and overall survival. A greater change in SUV at 6 and 12 months is associated with a greater change in PSA.

Tc-99m-MDP bone scans (TcBS) of 35 patients at baseline, 19 at 6 months and 14 at 12 months, were compared with the Na-F-18 PET/CT exams. The researchers found that the malignant lesions found with Na-F-18 PET/CT were classified as malignant with TcBS only 65 percent of the time.

In addition, 65 percent of the paired scans showed more lesions on Na-F-18 PET/CT than on TcBS. The researchers concluded that Na-F-18 PET/CT detects more bone metastases at an earlier stage than TcBS and improves the detection of new bone disease in high-risk patients.

“Our study suggests that NaF-PET/CT may be a useful imaging modality in the diagnosis, prognosis and follow-up of prostate cancer patients at high risk for bone metastasis," Dr. Andrea B. Apolo of the National Cancer Institute, said in a statement. "It provides a strong rationale to further the clinical development of NaF-PET/CT as a bone imaging tool in prostate cancer and other malignancies."

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