18F-fluoride PET/CT in clinical practice

No Added Value of 18F-Sodium Fluoride PET/CT for the Detection of Bone Metastases in Patients with Newly Diagnosed Prostate Cancer with Normal Bone Scintigraphy

“…In 2006, Even-Sapir demonstrated significantly improved diagnostic accuracy of NaF PET/CT in a head-to-head comparison with bone scintigraphy (4), whereas more recent diagnostic test accuracy studies have not entirely confirmed these results (9,10); in particular, false positive findings have been reported (5,11). NaF PET/CT has a high patient acceptance rate (12), and this technique may have an advantage over bone scintigraphy in terms of high patient throughput, thereby increasing patient capacity and the possibility of performing simultaneous contrast-enhanced CT as a ''one-stop-shop'' (13). Nevertheless, NaF PET/CT may be less cost-effective than bone scintigraphy (with or without SPECT/CT) (14), and access to a cyclotron and PET/CT scanner may be limited for various reasons.…”

Molecular imaging of bone metastasis

“…Its osseous uptake is due to chemisorption with exchange of 18 F ion for OH ion on the surface of the hydroxyapatite matrix of bone forming fluoroapatite and then migration of 18 F ion into the crystalline matrix of bone. Its binding to serum protein is minimal and is rapidly cleared through genitourinary tract resulting in quality images with high bone-to-background ratio in a shorter time [ 21 ]. The significance of synergistic evaluation of 18 F-FDG PET and 18 F-NaF PET for predicting time to skeletal-related events (tSRE), time to progression (TTP), and survival in patients with bone-dominant metastatic breast cancer is discussed in a prospective study by Peterson et al [ 22 ].…”