title: Combined 18F-NaF and 18F-FDG PET/CT in the Evaluation of Sarcoma Patients.
abstract: OBJECTIVE
  The combined administration of F-NaF and F-FDG in a single PET/CT scan has the potential to improve patient convenience and cancer detection. Here we report the use of this approach for patients with sarcomas.
  
  
  METHODS
  This is a retrospective review of 21 patients (12 men, 9 women; age, 19-66 years) with biopsy-proven sarcomas who had separate F-NaF PET/CT, F-FDG PET/CT, and combined F-NaF/F-FDG PET/CT scans for evaluation of malignancy. Two board-certified nuclear medicine physicians and 1 board-certified musculoskeletal radiologist were randomly assigned to review the scans. Results were analyzed for sensitivity and specificity, using linear regression and receiver operating characteristics.
  
  
  RESULTS
  A total of 13 patients had metastatic disease on F-NaF PET/CT, F-FDG PET/CT, and combined F-NaF/F-FDG PET/CT. Skeletal disease was more extensive on the F-NaF PET/CT scan than on the F-FDG PET/CT in 3 patients, whereas in 1 patient, F-FDG PET/CT showed skeletal disease and the F-NaF PET/CT was negative. Extraskeletal lesions were detected on both F-FDG and combined F-NaF/F-FDG PET/CT in 20 patients, with 1 discordant finding in the lung.
  
  
  CONCLUSIONS
  The combined F-NaF/F-FDG PET/CT scan allows for accurate evaluation of sarcoma patients. Further evaluation of this proposed imaging modality is warranted to identify the most suitable clinical scenarios, including initial treatment strategy and evaluation of response to therapy.
authors.affiliation: From the *Division of Nuclear Medicine and Molecular Imaging, Departments of †Radiation Oncology, ‡Medicine, and §Radiology, Stanford University Medical Center; Departments of ∥Radiology, ¶Bioengineering, and #Materials Science and Engineering, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA.
authors.forename: Tatianie
authors.initials: T
authors.lastname: Jackson
authors.forename: Camila
authors.initials: C
authors.lastname: Mosci
authors.forename: Rie
authors.initials: R
authors.lastname: von Eyben
authors.forename: Erik
authors.initials: E
authors.lastname: Mittra
authors.forename: Kristen
authors.initials: K
authors.lastname: Ganjoo
authors.forename: Sandip
authors.initials: S
authors.lastname: Biswal
authors.forename: Sanjiv Sam
authors.initials: SS
authors.lastname: Gambhir
authors.forename: Andrei
authors.initials: A
authors.lastname: Iagaru
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D012509:Sarcoma / Q000000981:diagnostic imaging* / Q000473:pathology; D012969:Sodium Fluoride / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D012969:Sodium Fluoride