Fluoride PET/CT

Various diseases of the skeletal system are associated with a metabolic change in the bone (e.g. bone metastases or primary bone tumors, but also a variety of benign diseases). Osteoblasts (bone-building cells) build up new bone substance much faster than is the case of a healthy bone. The radioactively labeled sodium fluoride (18F-fluoride) used in the fluoride-PET is incorporated into the bone matrix in the same way as phosphate and calcium, so that metabolically active areas of the bone can be made visible. Due to the fact that changes in the bone metabolism usually precede the changes in the morphological bone structure, various diseases can be diagnosed early with the 18F fluoride PET/CT (compared to X-ray imaging). Moreover, new therapeutic options (e.g. radionuclide therapy for bone metastases) may result from the storage behavior of malignant bone diseases in fluoride PET.

Indications

• Bone metastases:

1-    Detection

2-    Determination of the extent of disease (staging)

3-    Follow-up and therapy monitoring (monitoring)

• Primary bone tumors (detection and determination of the extent of disease)
• Identification of benign bone lesions
• Detection of skeletal lesions after traumatic events or chronic pain
• Determination of severity or localization of metabolic bone disorders (e.g. Paget's disease, osteoporosis, osteodystrophy, hyperparathyroidism)

Preparation for the investigation

You do not have to be in a fasting state to carry out the test successfully. Make sure you have a sufficient supply of fluids with you on the day of examination. You will receive the radiopharmaceutical, with a very short half-life (approx. 2 hours), which will be delivered specially for you. Please make sure you are present in the nuclear medicine clinic at the scheduled time.

Examination procedure

The patient's medical history will be reviewd and patient will be informed in detail about the examination by the responsible physician; followed by injection of the radioactively labeled 18F fluoride into an arm vein. After a waiting period of 60 minutes, in which the radioactive drug accumulates in the bone, the actual image acquisition is started at the PET scanner.  During the recording time (approx. 20 - 30 min) you have to stay still.

The PET-CT scanner is open on both ends (towards the head and the legs) unlike an MRI scanner, which is in form of a closed space at one end. However, in cases of pronounced claustrophobia, a premedication may be necessary or advisable to relieve the anxiety. Please keep in mind that under the influence of such an anxiolytic medication you will not be able to drive on the examination day! If there is no persistent "claustrophobia" (99% of cases), no such medication is required and you can drive your vehicle (before and after the examination).

No side effects are to be expected from the injection of the radioactive tracer itself.