Evolving Role of Molecular Imaging with (18)F-Sodium Fluoride PET as a Biomarker for Calcium Metabolism.
(18)F-sodium fluoride (NaF) as an imaging tracer portrays calcium metabolic activity either in the osseous structures or in soft tissue. Currently, clinical use of NaF-PET is confined to detecting metastasis to the bone, but this approach reveals indirect evidence for disease activity and will have limited use in the future in favor of more direct approaches that visualize cancer cells in the read marrow where they reside. This has proven to be the case with FDG-PET imaging in most cancers. However, a variety of studies support the application of NaF-PET to assess benign osseous diseases. In particular, bone turnover can be measured from NaF uptake to diagnose osteoporosis. Several studies have evaluated the efficacy of bisphosphonates and their lasting effects as treatment for osteoporosis using bone turnover measured by NaF-PET. Additionally, NaF uptake in vessels tracks calcification in the plaques at the molecular level, which is relevant to coronary artery disease. Also, NaF-PET imaging of diseased joints is able to project disease progression in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Further studies suggest potential use of NaF-PET in domains such as back pain, osteosarcoma, stress-related fracture, and bisphosphonate-induced osteonecrosis of the jaw. The critical role of NaF-PET in disease detection and characterization of many musculoskeletal disorders has been clearly demonstrated in the literature, and these methods will become more widespread in the future. The data from PET imaging are quantitative in nature, and as such, it adds a major dimension to assessing disease activity.
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
William
W
Raynor
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Sina
S
Houshmand
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Saeid
S
Gholami
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Sahra
S
Emamzadehfard
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Chamith S
CS
Rajapakse
Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.|Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Björn Alexander
BA
Blomberg
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Thomas J
TJ
Werner
Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
Poul F
PF
Høilund-Carlsen
Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.|Division of Rheumatology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.|Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.
Joshua F
JF
Baker
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA. abass.alavi@uphs.upenn.edu.
Abass
A
Alavi
D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging; D001416:Back Pain / Q000000981:diagnostic imaging; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000000981:diagnostic imaging; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000000981:diagnostic imaging; D016723:Bone Remodeling; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000378:metabolism; D002118:Calcium / Q000378:metabolism*; D004164:Diphosphonates / Q000627:therapeutic use; D018450:Disease Progression; D005462:Fluorine Radioisotopes; D015775:Fractures, Stress / Q000000981:diagnostic imaging; D006801:Humans; D007596:Joints / Q000000981:diagnostic imaging*; D057054:Molecular Imaging; D010003:Osteoarthritis / Q000000981:diagnostic imaging; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D012516:Osteosarcoma / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012969:Sodium Fluoride; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging; D016896:Treatment Outcome
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D012969:Sodium Fluoride; D002118:Calcium
18F-sodium fluoride; Metabolic bone disease; Positron emission tomography; Quantitative radionuclide imaging; Regional bone formation