Rev Esp Med Nucl. 2011;30(2):94–96 Clinical note Comparison of bone scintigraphy and 18 F-FDG PET-CT in a prostate cancer patient with osteolytic bone metastases P. Ozcan Kara a,* , T. Kara b , G. Kara Gedik a , O. Sari c , O. Sahin c a Department of Nuclear Medicine, Selcuklu Medical Faculty, Selcuk University, Selcuklu, Konya, Turkey b Department of Radiology, Beyhekim Hospital, Selcuklu, Konya, Turkey c Department of Nuclear Medicine, Meram Medical Faculty, Selcuk University, Meram, Konya, Turkey article info Article history: Received 1 April 2010 Accepted 20 October 2010 Available online 20 February 2011 Keywords: Prostate cancer Bone scintigraphy 18 F-FDG PET-CT Bone metastases abstract A 62 year-old male with prostate cancer, recently complaining lumbar pain with elevated PSA level (6.83 ng/ml) was referred for evaluating bone metastases. Bone scintigraphy with 99m Tc-MDP demonstrated intense uptake on third lumbar vertebra. Postoperative biopsy of the lesion on third lumbar vertebra revealed adenocarcinoma metastasis. For evaluating distant metastases and restaging, 18 F-FDG PET-CT was performed postoperatively. On PET-CT imaging there were cervical and left parailiac lymph nodes with FDG uptake, destruction on third lumbar vertebra level and intense soft tissue mass FDG uptake on the same area. Additionally, FDG uptake was detected on right iliac crest. On the CT images obtained by integrated PET-CT scanner, this uptake was matching with lytic bone metastases. The superiority of 18 F-FDG PET-CT for demonstrating osteolytic bone metastases compared to bone scintigraphy was presented in a case of prostate cancer in a patient with bone and lymph node metastases. © 2010 Elsevier España, S.L. and SEMNIM. All rights reserved. Comparación de la gammagrafía ósea y la 18 F-FDG PET-TAC en un paciente con cáncer de próstata con metástasis ósea osteolítica Palabras clave: Cáncer de próstata Gammagrafía ósea 18 F-FDG PET-TAC Metástasis óseas resumen Un varón de 62 a ˜ nos de edad con cáncer de próstata recientemente se queja de dolor lumbar con nivel elevado de PSA (6,83 ng/ml) y fue remitido para la evaluación de metástasis ósea. La gammagrafía ósea con 99m Tc-MDP demuestra una captación intensa en la tercera vértebra lumbar. La biopsia postoperatoria de la lesión en la tercera vértebra lumbar demostró una metástasis de adenocarcinoma. Para la evaluación de metástasis a distancia y la reclasificación se realizó 18 F-FDG PET-TAC después de la operación. En las imágenes PET-TAC cervical se captaron ganglios linfáticos parailíacos con la captación de FDG, la destrucción de tercer nivel de la vértebra lumbar y una intensa captación de una masa de tejidos blandos FDG en la misma área. Además, la captación de FDG se detectó en la cresta ilíaca derecha. En las imágenes de TAC obtenidas por escáner integrado de PET-TAC, esta captación encajaba con la metástasis ósea lítica. La superioridad de la 18 F-FDG PET-TAC para mostrar metástasis óseas osteolíticas en comparación con la gammagrafía ósea se presentó en un caso de cáncer de próstata en un paciente con metástasis en los ganglios linfáticos y los huesos. © 2010 Elsevier Espa ˜ na, S.L. and SEMNIM. Todos los derechos reservados. Introduction Bone metastases of solid tumors are common, and about 80% of them occur in patients with breast, lung or prostate cancer. Bone metastases can be suspected clinically and by laboratory tests; however, a final diagnosis relies on radiographic evidence. Bone metastases of prostate cancer usually have osteoblastic characteristics, manifested by pathological bone resorption and formation. Conventional bone scans with 99m Tc-methylene diphosphonate (MDP) are preferred to plain-film radiography for surveillance of the entire skeleton. Radiological diagnosis of bone metastases, particularly in patients with low burden of disease, * Corresponding author. E-mail address: ppelinozcan@gmail.com (P. Ozcan Kara). is difficult because non-cancerous bone lesions that mimic cancer are common. Bone metastases from prostate cancer usually form osteoblastic lesions but may be associated with mixed or osteolytic lesions as well. Prostate cancer is the most common malignancy among men in the western world. The natural pathway of the disease is often slow. In the United States, median age at diagnosis is 68 years and the overall 5-year relative survival rate is 99% 1 . Most patients are diagnosed with localized prostate cancer, whereas fewer than 10% have metastatic disease 1 . Thus, bone scintigraphy is performed at diagnosis only when high-risk features are present. Conventional bone scanning is still used as the most common procedure to assess bone metastases in prostate cancer which is routinely indicated in patients at high risk. However, it suffers from suboptimal specificity in the accurate differentiation of metastatic from benign processes. In this case report the superiority of 18 F-Fluorodeoxyglucose (FDG) 0212-6982/$ – see front matter © 2010 Elsevier España, S.L. and SEMNIM. All rights reserved. doi:10.1016/j.remn.2010.10.008 Document downloaded from http://www.elsevier.es, day 27/06/2016. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.