• Ferdinando CalabriaEmail author
  • Orazio Schillaci


18F-NaF PET/CT is a well-established and validated imaging tool for imaging skeletal system. The bio-distribution represents blood flow that varies among different bones; due to urinary excretion, bladder and kidneys can be normally visualized. The role of this tracer has been well demonstrated in imaging bone metastases, with sensitivity superior to 18F-FDG PET/CT and other conventional imaging modalities. In particular, 18F-NaF PET/CT can detect bone malignant involvement before lesions can be radiologically documented; however, a lack of specificity should be considered, due to the possibility of uptake in benign diseases as calcium deposits in brain and large arteries, osteoarthritis and post-traumatic lesions. Beyond oncology, this tracer can play a role in forensic use, evaluation of skeletal benign diseases, and atherosclerotic plaque.

18F-NaF uptake is also documented in meningioma, rheumatoid arthritis, amyloidosis, and lymphomas. Globally, nuclear medicine physicians must take into account the possibility of 18F-NaF uptake in all calcifications that can occur in benign or malignant diseases.


Bone 18F-NaF Skeleton Metastases PET/CT Pitfalls 







Computed tomography


European Association of Nuclear Medicine and Molecular Imaging


Food and Drug Administration


Maximum intensity projection


Positron emission computed tomography/computed tomography


Single photon emission computed tomography/computed tomography


Standardized uptake value


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Nuclear Medicine and Theranostics“Mariano Santo” HospitalCosenzaItaly
  2. 2.Department of Biomedicine and PreventionUniversity “Tor Vergata”RomeItaly
  3. 3.Department of Nuclear Medicine and Molecular ImagingIRCCS NeuromedPozzilliItaly

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