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Evolving Role of Molecular Imaging with 18F-Sodium Fluoride PET as a Biomarker for Calcium Metabolism

  • Imaging (T Lang and F Wehrli, Section Editors)
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Abstract

18F-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.

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Authors and Affiliations

  1. Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    William Raynor, Sina Houshmand, Saeid Gholami, Sahra Emamzadehfard, Thomas J. Werner & Abass Alavi

  2. Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Chamith S. Rajapakse

  3. Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark

    Björn Alexander Blomberg & Poul F. Høilund-Carlsen

  4. Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands

    Björn Alexander Blomberg

  5. Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA

    Joshua F. Baker

  6. Division of Rheumatology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Joshua F. Baker

  7. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA

    Joshua F. Baker

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  1. William Raynor
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  6. Björn Alexander Blomberg
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  7. Thomas J. Werner
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  8. Poul F. Høilund-Carlsen
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  9. Joshua F. Baker
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  10. Abass Alavi
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Correspondence to Abass Alavi.

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Raynor W, Houshmand S, Gholami S, Blomberg BA, Werner TJ, Høilund-Carlsen PF, Baker J, and Alavi A declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Imaging

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Raynor, W., Houshmand, S., Gholami, S. et al. Evolving Role of Molecular Imaging with 18F-Sodium Fluoride PET as a Biomarker for Calcium Metabolism. Curr Osteoporos Rep 14, 115–125 (2016). https://doi.org/10.1007/s11914-016-0312-5

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