Diagnosis and Monitoring of Osteoporosis With 18F-Sodium Fluoride PET: An Unavoidable Path for the Foreseeable Future

Reilly, Catherine; Raynor, William; Hong, Abigail L.; Kargilis, Daniel; Lee, Jae‐Shin; Alecxih, Austin G.; Gupta, Neeraj; Lim, Marie Kimberly; Al-Zaghal, Abdullah; Werner, Thomas; Rhodes, Sylvia S.; Alavi, Abass; Rajapakse, Chamith S.

doi:10.1053/j.semnuclmed.2018.07.007

Cited by 24 publications

(12 citation statements)

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“…While DXA remains the most frequently used modality to measure BMD and diagnose osteoporosis, it has several downsides. These limitations include low resolution to bone microarchitecture and quality, lack of three-dimensional information, and inability to discriminate between cortical and trabecular bone [ 7 , 39 ]. Since molecular alterations in the bone often precede gross structural changes seen in osteoporosis, use of modalities with greater resolution, depth, and molecular sensitivity, such as 18 F-NaF-PET/CT, could be revolutionary for early diagnosis of osteoporosis and other metabolic bone diseases.…”

Section: 18 F-naf-pet In Metabolic Bone Disordersmentioning

confidence: 99%

“…For instance, correlations between 18 F-NaF uptake measured by SUV and age at the humeral shaft and lumbar spine have been reported to show opposite trends [ 49 ]. Overall, the validation of 18 F-NaF-PET for the treatment and diagnosis of osteoporosis with further studies will certainly enhance the way metabolic bone diseases are diagnosed and treated [ 7 , 50 ].…”

Section: 18 F-naf-pet In Metabolic Bone Disordersmentioning

confidence: 99%

“…Autoimmune conditions can involve both excessive resorption and formation, which can result in spine fusion often seen in ankylosing spondylitis [ 6 ]. Regardless of the mechanism, symptoms and pathological manifestations of these conditions are often preceded by molecular alterations not adequately measured by traditional imaging techniques, such as radiographs or dual-energy X-ray absorptiometry (DXA) [ 7 ]. Therefore, development of imaging modalities sensitive to these microscopic changes could potentially revolutionize the early clinical management of conditions involving abnormal bone metabolism.…”

Section: Introductionmentioning

confidence: 99%

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18F-Sodium Fluoride PET as a Diagnostic Modality for Metabolic, Autoimmune, and Osteogenic Bone Disorders: Cellular Mechanisms and Clinical Applications

Park

Raynor

Sun

et al. 2021

IJMS

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In a healthy body, homeostatic actions of osteoclasts and osteoblasts maintain the integrity of the skeletal system. When cellular activities of osteoclasts and osteoblasts become abnormal, pathological bone conditions, such as osteoporosis, can occur. Traditional imaging modalities, such as radiographs, are insensitive to the early cellular changes that precede gross pathological findings, often leading to delayed disease diagnoses and suboptimal therapeutic strategies. 18F-sodium fluoride (18F-NaF)-positron emission tomography (PET) is an emerging imaging modality with the potential for early diagnosis and monitoring of bone diseases through the detection of subtle metabolic changes. Specifically, the dissociated 18F- is incorporated into hydroxyapatite, and its uptake reflects osteoblastic activity and bone perfusion, allowing for the quantification of bone turnover. While 18F-NaF-PET has traditionally been used to detect metastatic bone disease, recent literature corroborates the use of 18F-NaF-PET in benign osseous conditions as well. In this review, we discuss the cellular mechanisms of 18F-NaF-PET and examine recent findings on its clinical application in diverse metabolic, autoimmune, and osteogenic bone disorders.

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Section: 18 F-naf-pet In Metabolic Bone Disordersmentioning

confidence: 99%

Section: 18 F-naf-pet In Metabolic Bone Disordersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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18F-Sodium Fluoride PET as a Diagnostic Modality for Metabolic, Autoimmune, and Osteogenic Bone Disorders: Cellular Mechanisms and Clinical Applications

Park

Raynor

Sun

et al. 2021

IJMS

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“…Bone imaging with functional modalities such as PET is a sensitive method that can overcome the limitations associated with other bone turnover assessments. 146,147 A study by Piert and colleagues 148 used NaF-PET to assess bone turnover at the vertebrae of healthy pigs and compared their findings with histomorphometric data derived from iliac crest biopsies. The influx rate and volume flux of NaF were found to correlate with the mineral apposition rate, and the investigators concluded that NaF-PET may represent a noninvasive method of following metabolic bone diseases over time, decreasing the need for invasive bone biopsies.…”

Section: Metabolic Bone Diseasesmentioning

confidence: 99%

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

et al. 2021

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The bone-seeking properties of 18 F-sodium fluoride (NaF) were first described in 1962 by Blau and colleagues, 1 who used this positron-emitting radiotracer in skeletal scintigraphy. Both high uptake by bone and rapid plasma clearance of NaF were determined to be advantages in imaging skeletal metabolism. 2 The mechanism of NaF uptake relies on the exchange of OH À for 18 F À , converting hydroxyapatite on the surface of the bone matrix to fluorapatite. 2,3 One hour after NaF is administered intravenously, only 10% remains in the plasma compartment because of a first-pass Conflict of interest: The authors have declared no conflicts of interest.

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“…Sodium Fluoride ([ 18 F]NaF) Positron Emission Tomography-Computed Tomography (PET/CT) is used clinically in oncology patients to detect and characterize osteoblastic metastatic lesions (1)(2)(3)(4), as well as to aid visualization of atherosclerotic calcifications and plaques in patients with cardiovascular disease (5)(6)(7). Recently, [ 18 F]NaF has also been used as a bone imaging biomarker to assess and quantify bone metabolic processes (i.e., osteoblastic activity) in non-oncologic musculoskeletal disorders such as osteoarthritis and osteoporosis (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The radiolabeled fluoride ion exchanges with the hydroxyl groups in hydroxyapatite crystals on the surface of the bone matrix to form fluoroapatite.…”

Section: Introductionmentioning

confidence: 99%

[18F] Sodium Fluoride Dose Reduction Enabled by Digital Photon Counting PET/CT for Evaluation of Osteoblastic Activity

et al. 2022

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The aim of the study was to assess the quality and reproducibility of reducing the injected [18F] sodium fluoride ([18F]NaF) dose while maintaining diagnostic imaging quality in bone imaging in a preclinical skeletal model using digital photon counting PET (dPET) detector technology. Beagles (n = 9) were administered three different [18F]NaF doses: 111 MBq (n = 5), 20 MBq (n = 5), and 1.9 MBq (n = 9). Imaging started ≃45 min post-injection for ≃30 min total acquisition time. Images were reconstructed using Time-of-Flight, ultra-high definition (voxel size of 1 × 1 × 1 mm3), with 3 iterations and 3 subsets. Point spread function was modeled and Gaussian filtering was applied. Skeleton qualitative and quantitative molecular image assessment was performed. The overall diagnostic quality of all images scored excellent (61%) and acceptable (39%) by all the reviewers. [18F]NaF SUVmean showed no statistically significant differences among the three doses in any of the region of interest assessed. This study demonstrated that a 60-fold [18F]NaF dose reduction was not significantly different from the highest dose, and it had not significant effect on overall image quality and quantitative accuracy. In the future, ultra-low dose [18F]NaF dPET/CT imaging may significantly decrease PET radiation exposure to preclinical subjects and personnel.

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Diagnosis and Monitoring of Osteoporosis With 18F-Sodium Fluoride PET: An Unavoidable Path for the Foreseeable Future

Cited by 24 publications

References 50 publications

18F-Sodium Fluoride PET as a Diagnostic Modality for Metabolic, Autoimmune, and Osteogenic Bone Disorders: Cellular Mechanisms and Clinical Applications

18F-Sodium Fluoride PET as a Diagnostic Modality for Metabolic, Autoimmune, and Osteogenic Bone Disorders: Cellular Mechanisms and Clinical Applications

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

[18F] Sodium Fluoride Dose Reduction Enabled by Digital Photon Counting PET/CT for Evaluation of Osteoblastic Activity

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