Imaging of A Single Malignant Osseous Involvement by F-18 NaF PET/CT

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Pawana Pusuwan, MD
Tawatchai Ekjeen, MSc
Kobkun Maungsomboon, MD
Ruentip Tiparoj, MSc
Chiraporn Tocharoenchai, PhD
Ananya Ruangma, PhD


Since the introduction of Tc-99m methylene diphosphonate (Tc-99m MDP) for bone imaging in 1971 by Subramanian and McAfee, bone scans have become one of the most widely used investigations in nuclear medicine for malignant osseous involvement.1 After its introduction by Blau et al in 1962, F-18 NaF was recognized as an excellent radiopharmaceutical for skeletal imaging, several decades before the introduction of the PET system.2,3

In the early 1990s, Phelp et al used F-18 NaF as a model for the development of whole body PET because of the favorable skeletal kinetics of F-18 NaF.3 It was reported that F-18 NaF PET/CT improved the clinician’s ability to identify the presence and extent of bone metastases.3 We report our rst experience using this technique in localizing a single skeletal metastasis at Siriraj Hospital.

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Pusuwan P, Ekjeen T, Maungsomboon K, Tiparoj R, Tocharoenchai C, Ruangma A. Imaging of A Single Malignant Osseous Involvement by F-18 NaF PET/CT. BKK Med J [Internet]. 2013 Sep. 20 [cited 2024 Jun. 18];6(1):68. Available from:
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2. Blau M, Nagler W, Bender MA. Fluorine-18: a new isotope for bone scanning. J Nucl Med 1962;3:332-4.
3. Grant FD, Fahey FH, Packard AB, et al. Skeletal PET with 18F-fluoride: applying new technology to an old tracer. J Nucl Med 2008;49:68-78.
4. Schirrmeister H, Guhlmann A, Elsner K, et al. Sensitivity in detecting osseous lesions depends on anatoic localization: planar bone scintigraphy versus 18F PET. J Nucl Med 1999;40:1623-9.
5. The science of molecular imaging. 18F sodium fluoride bone PET. Is there a better bone scan in your future? (Accessed April 13, 2013, at http// CME/PresenterItems/EventID_41/PresenterItemsTyp eID_41/F18 Sodium Fluoride Minerich.pdf)