NaF-18 PET/CT Bone Scans

NaF-18 or F-sodium fluoride bone scans use a positron-emitting radionuclide to provide physiologic information of bone. Sodium fluoride bone scans are highly sensitive for bone metastatic disease of both osteoblastic and osteolytic cancers. With NaF-18, bone metastases are seen at sites of high bone turnover and remodeling, and therefore, is used to detect and follow up bone metastases. Compared to regular bone scans, NaF-18 bone scans provide higher accuracy in differentiating benign from malignant lesions, as given below.

The PET-CT Center Atrium Health Navicent is proud to be a
NOPR (National Oncologic PET Registry) participant


Advantages of NaF 18 PET over Tc-MDP SPECT (regular bone scan)

NaF 18 PET Special Bone Scan

Higher spatial resolution of dedicated PET systems provide superior image quality
Accurate transmission whole body attenuation correction routinely available on PET systems
Small axial field of view of PET scanner limits area of the skeleton studied
Rapid clearance and short half-life (110 min), whole body tomography allows total acquisition time of 70-90 minutes. Injection->end of scan - 120-150 minutes
Renal clearance. Adequate hydration improves image quality.
Higher accuracy in detecting both osteolytic and osteoblastic metastases
Higher accuracy in differentiating benign from malignant lesions


99 mTc Regular Bone Scan

Gamma camera SPECT systems have poorer spatial resolution
Attenuation correction, if available, developed for cardiac PET, not whole body imaging
Larger area of the skeleton included in SPECT field of view
Slower clearance and longer half-life (6 hrs), planar whole body and multiple SPECT acquisisions require a total time of 120-180 minutes. Injection->end of scan - 200-270 minutes
Renal clearance. Hydration and frequent urination decreases, interfering with bladder and kidney activity
Overall high sensitivity for detecting bone metastases, planar techniques demonstrate lower sensitivity in detection of vertebral metastases, multiple SPECT studies must be performed to approach sensitivity of PET
Limited specificity in differentiating benign from malignant bone lesions