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J Nucl Med Technol. 2016 Dec;44(4):217-222. Epub 2016 Sep 15.

The Role of 18F-Sodium Fluoride PET/CT Bone Scans in the Diagnosis of Metastatic Bone Disease from Breast and Prostate Cancer.

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Queensland X-Ray, Cairns Private Hospital, Cairns, Australia
Department of Nuclear Medicine, Royal Liverpool Hospital, Liverpool, United Kingdom; and.
School of Health Sciences, University of Salford, Salford, United Kingdom.


We describe the role of 18F-sodium fluoride (18F-NaF) PET/CT bone scanning in the staging of breast and prostate cancer. 18F-NaF PET was initially utilized as a bone scanning agent in the 1960s and early 1970s, however, its use was restricted by the then-available γ-cameras. The advent of hybrid PET/CT cameras in the late 1990s has shown a resurgence of interest in its use and role. After a brief introduction, this paper describes the radiopharmaceutical properties, dosimetry, pharmacokinetics, and mechanism of uptake of 18F-NaF. The performance of 18F-NaF PET/CT is then compared with that of conventional bone scintigraphy using current evidence from the literature. Strengths and weaknesses of 18F-NaF PET/CT imaging are highlighted. Clinical examples of improved accuracy of diagnosis and impact on patient management are illustrated. Limitations of 18F-NaF PET/CT imaging are outlined.


18F-sodium fluoride PET/CT; 99mTc-MDP; bone metastases; bone scintigraphy; breast cancer; prostate cancer

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