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Sodium 18F-Fluoride PET/CT Bone Scans 1.0

Recent clinical studies have shown that Sodium Fluoride (F18-NaF) has proven to be a superior imaging agent in the diagnosis of bone metastasis.  NaF bone scanning detects 45% more metastases in the spine as compared to standard bone scans.  A fusion CT allows immediate comparisons without the inconvenience of additional imaging.

 

What is a Sodium Fluoride PET Bone Scan used for?

This PET scan is used specifically to confirm the presence of bone metastasis in a patient with diagnosed cancer.   This exam also provides a full body scan in a shorter time compared to standard bone scans.

18F-Sodium Fluoride (NaF) PET/CT is an important tool for detecting and evaluating metastatic bone cancer. These bone studies are particularly useful, since some of the most prevalent cancers are commonly associated with metastatic bone disease, such as breast and prostate cancer, as well as carcinoma of the thyroid, kidney, and lung. This expansion of coverage for 18F-Sodium Fluoride (NaF) studies provides a superior clinical alternative for bone scanning, with significant advantages over “conventional” 99mTc-MDP bone scans, including higher sensitivity and specificity, shorter uptake and scan times, and radiation doses comparable to 99mTc-MDP studies.

From an operational standpoint, the faster completion of whole body scanning with 18F-Sodium Fluoride (NaF) PET/CT is significant, providing greater comfort and convenience for the patient. While the waiting time between radiopharmaceutical injection and the actual scan is 60 minutes for 18F-Sodium Fluoride (NaF) PET/CT, the waiting time for a conventional bone scan is 3 to 4 hours. The actual scanning time for the 18F-Sodium Fluoride (NaF) PET/CT is generally 20-30 minutes, as compared with 30-60 minutes for the conventional bone scan.

 

Better than conventional bone scans

Until recently, Medicare and Medicaid reimbursed only for conventional bone scans in patients whose cancers were suspected to have spread to their bones. But a research program run by the Centers for Medicare & Medicaid Services now allows eligible Medicare patients to receive reimbursement for NaF PET/CT scans.

Notice the greater sensitivity of the PET Bone Scan over the Conventional Bone Scan in the following 2 images:

MDP Bone Scan  NaF PETCT
Conventional Bone Scan                        PET Bone Scan

“It’s important for referring physicians to be aware that this type of scan exists, and that the data available to date from various studies show that a PET/CT scan with the NaF tracer is actually a better test for bone imaging,” says Martin Allen-Auerbach, M.D., clinical director of the Division of Nuclear Medicine in UCLA’s Department of Molecular & Medical Pharmacology. The test is particularly helpful in determining the presence of bone metastases in patients with cancers of the prostate, breast, lung kidneys and thyroid — cancers that are prone to spread to the bones, he says. “From the scientific data that’s available, PET/CT with NaF is the better exam,” Dr. Auerbach says. “It’s more sensitive and more specific than a regular bone scan.”

 

More info:

SNM Practice Guideline for Sodium 18F-Fluoride PET/CT Bone Scans 1.0
November 1, 2010; 51 (11)
 The Journal of Nuclear Medicine, November 1, 2010; 51 (11)

http://emedicine.medscape.com/article/387840-overview