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Skeletal PET with ¹⁸F-Fluoride: Applying New Technology to an Old Tracer^*

¹ Division of Nuclear Medicine/PET, Children's Hospital Boston, Boston, Massachusetts; ² Harvard Medical School, Boston, Massachusetts; ³ Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; and ⁴ University of Pennsylvania Medical School, Philadelphia, Pennsylvania

Correspondence: For correspondence or reprints contact: S. Ted Treves, MD, Children's Hospital Boston, 300 Longwood Ave., PV2C12, Boston, MA 02115. E-mail: ted.treves{at}childrens.harvard.edu

Although ¹⁸F-labeled NaF was the first widely used agent for skeletal scintigraphy, it quickly fell into disuse after the introduction of ^99mTc-labeled bone-imaging agents. Recent comparative studies have demonstrated that ¹⁸F-fluoride PET is more accurate than ^99mTc-diphosphonate SPECT for identifying both malignant and benign lesions of the skeleton. Combining ¹⁸F-fluoride PET with other imaging, such as CT, can improve the specificity and overall accuracy of skeletal ¹⁸F-fluoride PET and probably will become the routine clinical practice for ¹⁸F-fluoride PET. Although ¹⁸F-labeled NaF and ^99mTc-diphosphonate have a similar patient dosimetry, ¹⁸F-fluoride PET offers shorter study times (typically less than 1 h), resulting in a more efficient workflow, improved patient convenience, and faster turnarounds of reports to the referring physicians. With the widespread availability of PET scanners and the improved logistics for the delivery of ¹⁸F radiopharmaceuticals, prior limitations to the routine use of ¹⁸F-fluoride bone imaging have largely been overcome. The favorable imaging performance and the clinical utility of ¹⁸F-fluoride PET, compared with ^99mTc-diphosphonate scintigraphy, support the reconsideration of ¹⁸F-fluoride as a routine bone-imaging agent.

Key Words: ¹⁸F-labeled sodium fluoride, skeletal PET

^* NOTE: FOR CE CREDIT, YOU CAN ACCESS THIS ACTIVITY THROUGH THE SNM WEB SITE (http://www.snm.org/ce_online) THROUGH JANUARY 2009.

No potential conflict of interest relevant to this article was reported.

COPYRIGHT © 2008 by the Society of Nuclear Medicine, Inc.

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