Opportunistic osteoporosis screening on FDG PET/CT scans in breast carcinoma: a comparison with DXA

Articles in Press

Document Type : Original Article

Authors

1 Department of Nuclear medicine Dr Rajendra Prasad government medical college

2 PGIMER, sector 12 Chandigarh

10.22038/aojnmb.2025.86503.1619

Abstract

Introduction: Reduced bone mineral density is often observed in breast cancer patients. Routine PET/CT scans can be used for detection of low bone mineral density.

Aim: To evaluate prevalence of osteopenia, osteoporosis and fracture risk in pre and post-therapy breast carcinoma patients undergoing 18F-FDG PET/CT scans.

Materials and methods: In this retrospective study L1-L4 vertebral and femoral neck CT mean Hounsfield unit attenuation and their corresponding SUVmax values from initial staging and end of treatment FDG PET/CT scans performed breast carcinoma patients were compared. Post chemo ± hormonal therapy FDG PET/CT HU values were also compared to DXA scan T- scores.

Results: Significant increase in prevalence of post chemo ± hormonal therapy osteopenia, osteoporosis and fractures (62%, 18% and 16% vs baseline of 35%, 4% and 9% respectively). CECT mean attenuation values of ≤ 174.6 HU and ≤ 117.2 HU for detection of osteopenia and osteoporosis with sensitivity of 100% and specificity of 94.2 % for L1-L4 vertebrae, and ≤ 176.8 HU and ≤ 117.8 HU for osteopenia and osteoporosis with sensitivity of 100% and specificity 96.4% at femoral necks respectively were suggested. Furthermore, mean attenuation values of ≤ 125.9 HU with sensitivity and specificity of ~ 100% and 79% and ≤ 124.8 HU with sensitivity of 100% and specificity ~ 79.8% were suggested for increased L1-L4 vertebral and femoral neck fractures prevalence/ risk respectively. An associated post chemo ± hormonal therapy decline in vertebral and femoral neck mean SUVmax values in range of 14% was also observed.

Keywords

Main Subjects

Asia Oceania Journal of Nuclear Medicine and Biology

Articles in Press, Accepted Manuscript
Available Online from 31 August 2025

Files

Share

How to cite

Statistics