The Role of ¹⁸F-NaF Skeletal PET/CT in Oncology

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 24, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 0.50
Procedures: 0.50
Head, Spine, and Musculoskeletal: 0.50

Nuclear Medicine Technology: 3.00
Procedures: 3.00
Radionuclides and Radiopharmaceuticals: 0.50
Endocrine and Oncology Procedures: 0.50
Other Imaging Procedures: 2.00

Outline

1. Introduction
2. Sodium Fluoride ¹⁸F
3. Pharmacokinetics and Biologic Properties
4. Comparison of ¹⁸F-NaF and ^99mTc-MDP as Bone Agents
5. Clinical Indications
6. ¹⁸F-NaF PET/CT Protocol
7. Radiation Dosimetry
8. Image Interpretation
9. Extraosseous Uptake of ¹⁸F-NaF
10. Limitations
11. Comparison of ¹⁸F-NaF PET/CT and FDG PET/CT: Which Examination Should Be Performed
12. Conclusions

Objectives

Upon completion of this course, students will:

1. be familiar with the FDA approval of ¹³¹Iodine
2. identify which cancer is commonly treated with radioiodine
3. identify what cells comprise the thyroid gland
4. be familiar with the role of radioiodine in medullary thyroid cancer
5. identify the undifferentiated thyroid cancer cells
6. identify the differentiated thyroid cancer subtypes
7. identify the categories of radioiodine use for thyroid cancer
8. be familiar with the thyroid cancer risks after remnant ablation
9. be familiar with criteria for patient selection for adjuvant therapy
10. understand the meaning of radioactive iodine therapy
11. be familiar with the level of toxicity for thyroid cancer treatment
12. identify the organizational guidelines for thyroid cancer therapy
13. be familiar with ATA guidelines for thyroid cancer patients not requiring radioiodine therapy
14. be familiar with the tumor size criterion for whom radioiodine therapy is definitely recommended
15. identify the criteria for radioactive iodine therapy
16. be familiar with the radioactive properties of ¹³¹Iodine
17. be familiar with the factors taken into account when selecting a radioiodine dose for therapeutic intent
18. identify who is credited with the whole-body and blood dosimetry for radioiodine therapy
19. identify the radioisotope of iodine that is positron emitting
20. be familiar with the advantage of using ¹²⁴Iodine for quantification of individual thyroid lesions
21. be able to define iodine-refractory disease
22. identify the drug approved in 2013 for use in iodine-refractory disease
23. be familiar with the PET/CT radiopharmaceutical used to help stratify iodine refractory disease
24. identify the role of selemetinib in iodine-refractory disease
25. be familiar with the signaling pathways exploited in thyroid cancer
26. understand the role that sorafenib plays in the treatment of iodine-refractory disease
27. identify tumor cells signaling pathways that sorafenib effects
28. be familiar with the disadvantages of current targeted therapeutics
29. identify ¹³¹Iodine as a theranostic agent
30. understand the potential ¹²⁴Iodine PET/CT may have on response to radioiodine therapy