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CC BY-NC-ND 4.0 · World J Nucl Med 2018; 17(04): 281-285
DOI: 10.4103/wjnm.WJNM_87_17
Original Article

Prostate-specific antigen cutoff value for ordering sodium fluoride positron emission tomography/computed tomography bone scan in patients with prostate cancer

Ismet Sarikaya
Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait City
,
Ali Sarikaya
1   Department of Nuclear Medicine, Faculty of Medicine, Trakya University, Edirne
,
Abdelhamid Elgazzar
Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait City
,
Vuslat Caloglu
2   Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne
,
Prem Sharma
3   Department of Statistics, Faculty of Medicine, Kuwait University, Kuwait City
,
Ali Baqer
4   Department of Nuclear Medicine, Mubarak Al-Kabeer Hospital, Kuwait City
,
Murat Caloglu
2   Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne
,
Mahmoud Alfeeli
4   Department of Nuclear Medicine, Mubarak Al-Kabeer Hospital, Kuwait City
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The use of F-18 sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT) bone scan is increasing because of its higher sensitivity and specificity over standard bone scintigraphy (BS). Studies previously reported a prostate-specific antigen (PSA) cutoff value for ordering standard BS. However, this has not been determined for NaF PET yet. In this study, our goal was to determine a PSA cutoff level for ordering NaF PET/CT bone scan. Newly diagnosed and previously treated prostate cancer patients who had NaF PET/CT scan and PSA measurements within 2 mos of PET study were selected for analysis. When available, other parameters, such as Gleason score (GS), clinical stage, alkaline phosphatase levels, skeletal symptoms, and correlative image findings, were recorded. Receiver operating characteristic (ROC) analysis was performed to determine PSA cutoff values. Sixty-two patients (32 newly diagnosed and 30 previously treated) met the inclusion criteria. Near half of previously treated patients were on hormone therapy. NaF PET/CT was positive in 9 newly diagnosed (PSA mean: 91.6 ng/ml, range: 6.2–226 ng/ml) and in 6 previously treated patients (PSA mean: 146.4 ng/ml, range: 6.6–675 ng/ml). ROC analysis indicated that PSA cutoff value for NaF PET/CT positivity was >20 ng/ml in newly diagnosed and >6 ng/ml in previously treated patients. PSA cutoff value for ordering NaF PET/CT in newly diagnosed patients does not seem significantly different than the previous results for BS (>20 ng/ml). However, we found a lower PSA cutoff value of >6 ng/ml in previously treated patients.

Keywords

Cutoff - F-18 sodium fluoride - positron emission tomography/computed tomography - prostate cancer - prostate-specific antigen - sodium fluoride


Publication History

Article published online:
17 May 2022

© 2018. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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