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Fluoride Kinetics of the Axial Skeleton Measured in Vivo with Fluorine-18-Fluoride PET

Departments of Nuclear Medicine and Internal Medicine, University Hospital Gasthuisberg; Laboratory of Radiopharmaceutical Chemistry, KU Leuven, Leuven, Belgium

Correspondence: For correspondence or reprints contact: Christiaan Schiepers, MD, PhD, Department of Radiological Sciences, Olive View-UCLA Medical Center, 14445 Olive View Drive, Sylmar, CA91342.

ABSTRACT

The aim of this study was to quantify regional bone blood flow and influx rate with PET and [¹⁸F]fluoride in patients with metabolic bone disorders. Methods: Dynamic imaging of the spine or pelvis was performed after administration of 300–370 MBq of ¹⁸F^–. Plasma clearance of ¹⁸F^– was determined in blood sampled from the radial artery. A three-compartment model was used to estimate the regional flow and fluoride influx rate. Results: In this preliminary study, fluoride flux (in µmol/min/liter) could be measured regionally. The flux was consistent with the pathophysiology of the studied metabolic disorders and allowed the various disease states to be distinguished. Bone blood flow and influx rate were low in osteoporosis (in the "normal-appearing" bone) and high in Paget's disease. Conclusion: With PET and [¹⁸F]fluoride, local bone blood flow and fluoride influx rate can be quantified in patients in vivo. Metabolically active zones have an increased influx rate and an accordingly increased flow. In principle, this technique permits classification of bone disorders and has potential for the monitoring of therapy response in metabolic bone disease.

Key Words: ¹⁸F • skeletal flow • PET • metabolic bone disease

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