Combined FDG and [F-18]fluoride whole-body PET: A feasible two-in-one approach to cancer imaging?

PURPOSE: To evaluate the diagnostic usefulness of the combined application of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG; for the evaluation of soft tissue) and [F-18]fluoride (for the evaluation of the skeleton) in positron emission tomography (PET) of cancer. MATERIALS AND METHODS: Sixty consecutive patients (23 women, 37 men; mean age +/- SD, 51 years +/- 14; age range, 13-76 years) were entered into this prospective study. Thirty patients underwent only FDG PET. Thirty patients underwent combined FDG and fluoride PET. The PET findings were correlated with the findings of other imaging modalities. Interobserver agreement for the anatomic lesion localization was calculated with the use of the kappa statistic. RESULTS: All 30 combined FDG and fluoride studies yielded high-quality whole-body images. PET findings correlated with other imaging findings in 54 (78%) of 69 lesions in the control group and with 64 (88%) of 73 lesions in the combined group. Interobserver agreement in the control group was 0.74; it was 0.95 in the combined group. CONCLUSION: Combined FDG and fluoride PET is an advanced metabolic imaging approach for the evaluation of cancer.