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

A review of the indications, imaging appearances, and utility of 18F-NaF PET/CT in the evaluation of skeletal disease.

Course ID: Q00420 Category:
Modalities: , , ,

2.5

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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[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: 2.50
Procedures: 2.50
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. know the primary tumor types which are most likely to metastasize to bone
  2. identify the device which produces nearly all of the clinically used 18F-NaF
  3. know how 18F-NaF uptake indicates osteoblastic activity
  4. understand why18F-NaF patients can be imaged 1 hour or less post injection
  5. know the advantages of bone imaging with 99mTc-MDP over 18F-NaF
  6. identify imaging modalities that improve 99mTc-MDP bone imaging specificity
  7. identify the area of the body where the superior spatial resolution of 18F-NaF is particularly important
  8. identify the initial imaging modality of choice for the evaluation of suspected child abuse
  9. understand how 18F-NaF imaging can benefit in the characterization of the biology of atherosclerotic plaques
  10. know the factors that affect the time of imaging per bed position for 18F-NaF
  11. be familiar with the reasons for encouraging hydration for 18F-NaF imaging
  12. understand the factors which effect radiation dosimetry in 18F-NaF PET/CT
  13. identify the organ/structure which receives the highest radiation dose in 18F-NaF PET imaging
  14. know the normal uptake pattern of 18F-NaF within the body
  15. understand the mechanism by which metastatic lesions are visualized in 18F-NaF bone imaging
  16. be familiar with what the discovery of bone metastases from breast cancer may indicate for a patient
  17. be familiar with benign processes demonstrating increased 18F-NaF uptake
  18. understand possible implications of 18F-NaF uptake in atherosclerotic plaque
  19. know the possible interpretation of spinal lesions not associated with the endplate or joint surface that do not show a typical 18F-NaF uptake pattern
  20. be familiar with the differences in 18F-NaF and FDG prospective evaluations