RT Journal Article SR Electronic T1 Validation of the Semiautomatic Quantification of 18F-Fluoride PET/CT Whole-Body Skeletal Tumor Burden JF Journal of Nuclear Medicine Technology JO J. Nucl. Med. Technol. FD Society of Nuclear Medicine SP 378 OP 383 DO 10.2967/jnmt.118.211474 VO 46 IS 4 A1 Ana E. Brito A1 Felipe Mourato A1 Allan Santos A1 Camila Mosci A1 Celso Ramos A1 Elba Etchebehere YR 2018 UL http://tech.snmjournals.org/content/46/4/378.abstract AB Our purpose was to validate a semiautomatic quantification of the skeletal tumor burden on 18F-fluoride PET/CT using manual quantification as a reference. Methods: We quantified 51 18F-fluoride PET/CT examinations performed on female breast cancer patients. Clinical information (age; time of disease presentation; presence of visceral metastases; and time to death, progression, or a bone event) was recorded. The total volume of 18F-fluoride–avid skeletal metastases and the total activity of 18F-fluoride–avid metastases were calculated manually and semiautomatically. Results: Manual and semiautomatic metrics correlated strongly (P < 0.0001; 95% confidence interval, 0.9300–0.9769). On multivariable analysis, the semiautomatic measures of total activity for 18F-fluoride–avid metastasis correlated significantly with overall survival (P = 0.0001) and progression-free survival (P = 0.0006). Approximate times for calculating skeletal tumor burden (semiautomatic vs. manual) were, respectively, 30 s versus 321 s in patients with fewer than 5 metastases, 120 s versus 640 s in patients with 5–10 metastases, and 240 s versus 1207s in patients with more than 10 metastases. Conclusion: Semiautomatic quantification of whole-body 18F-fluoride PET/CT skeletal tumor burden can replace manual quantification in breast cancer patients and is a strong independent biomarker of prognosis.