Metastatic prostate cancer: Initial findings of PET with 2-deoxy-2-[F-18]fluoro-D-glucose

PURPOSE: To evaluate the accuracy of positron emission tomography (PET) with 2-deoxy-2[fluorine-18]fluoro-D-glucose (FDG) in the detection of osseous and soft-tissue metastases of prostate cancer. MATERIALS AND METHODS: Thirty-four patients (mean age, 71 years) with biopsy-proved prostate cancer and known or suspected metastatic disease were examined. Blinded interpretation of the PET images was compared with bone scan, CT, and clinical follow-up findings. RESULTS: In 202 untreated osseous metastases in 22 patients, the sensitivity of FDG PET was 65% (131 of 202 metastases), with a positive predictive value of 98% (131 of 133 positive findings). The estimated standardized uptake value in metastases was 2.1-5.7. Soft-tissue metastases to the lymph nodes or liver were identified, but evaluation of pelvic lymph node metastases was severely limited because of bladder tracer activity. CONCLUSION: FDG PET can help identify osseous and soft-tissue metastases of prostate cancer with a high positive predictive value but is less sensitive than bone scintigraphy in the identification of osseous metastases.