Molecular imaging in oncology: (18)F-sodium fluoride PET imaging of osseous metastatic disease

AJR Am J Roentgenol. 2014 Aug;203(2):263-71. doi: 10.2214/AJR.13.12158.


Objective: This literature review details the history, pharmacokinetics, and utility of (18)F-sodium fluoride (Na(18)F) PET/CT in detecting osseous metastases compared with the current standard of care, technetium-99m methylene diphosphonate ((99m)Tc-MDP) bone scintigraphy. Additional discussion highlights solutions to impediments for broader implementation of this modality and insight into the complementary roles of (18)F-FDG PET/CT and Na(18)F PET/CT in oncology imaging, including preliminary data for combined Na(18)F and FDG PET/CT.

Conclusion: Na(18)F PET/CT is the most comprehensive imaging modality for the evaluation of osseous metastatic disease. Although further data acquisition is necessary to expand cost-benefit analyses of this imaging agent, emerging data reinforce its diagnostic advantage, suggest methods to mitigate impediments to broader utilization of Na(18)F PET/CT, and introduce a potentially viable technique for single-session combined Na(18)F and FDG PET/CT staging of soft-tissue and osseous disease.

Keywords: PET; bone metastasis; cancer staging; oncology; sodium fluoride.

Publication types

  • Review

MeSH terms

  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / secondary
  • Fluorine Radioisotopes* / pharmacokinetics
  • Humans
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals / pharmacokinetics
  • Sodium Fluoride* / pharmacokinetics
  • Technetium Tc 99m Medronate / pharmacokinetics


  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Sodium Fluoride
  • Technetium Tc 99m Medronate