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Can we achieve a radionuclide radiation dose equal to or less than that of 99mTc-hydroxymethane diphosphonate bone scintigraphy with a low-dose 18F-sodium fluoride time-of-flight PET of diagnostic quality?

Nuclear medicine communications (2013-03-09)
Jessica Ohnona, Laure Michaud, Sona Balogova, Frédéric Paycha, Valérie Nataf, Paul Chauchat, Jean-Noël Talbot, Khaldoun Kerrou
ABSTRACT

18F-Sodium fluoride is a bone tracer with a high signal-to-noise ratio, but its dosimetry is higher than that of 99mTc-labeled phosphonates at the recommended activities. The study's purpose was to determine whether the reduction by half of F-sodium fluoride-injected activity, mimicked by a short-timed reconstruction image, simulating a total dose less than or equal to that of 99mTc-hydroxymethane diphosphonate scintigraphy, had an impact on the accuracy of PET semiquantitative measurements and image quality. Whole-body time-of-flight 18F-sodium fluoride PET/computed tomography (CT) images were acquired prospectively from 40 adult patients for detection of bone metastases. 18F-Sodium fluoride was administered according to the European Association of Nuclear Medicine (EANM) and Society of Nuclear Medicine (SNM) practice guidelines. From the acquired 1 min/bed position list-mode data, 30-s reconstructions were extracted. Measurements of maximum standard uptake value were recorded with a region of interest applied to the same location on the 1-min and 30-s images, which were displayed side by side, and were analyzed using Bland-Altman plots. A masked reading was performed by two senior nuclear medicine physicians who counted the foci of visually increased uptake. Bland-Altman plots showed an excellent agreement between the maximum standard uptake value measurements of the 60- and 30-s images. The paired Wilcoxon test results between the corresponding 60- and 30-s images read by masked readers A and B were not significant (P=0.15 and 0.19, respectively). Reducing acquisition duration by half or injecting half of the activity recommended by the EANM and SNM practice guidelines can lead to 18F-sodium fluoride time-of-flight PET images of diagnostic quality, achieving a radiation dose less than or equal to that of 99mTc-labeled phosphonates.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Sodium fluoride, ACS reagent, ≥99%
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Fluoride ion solution for ISE, 0.1 M F-, analytical standard (for ion-selective electrodes)
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Sodium fluoride 0.5 M solution
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Sodium fluoride, anhydrous, powder, 99.99% trace metals basis
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Sodium fluoride, ReagentPlus®, ≥99%
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Sodium fluoride solution
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Sodium fluoride, puriss., 98.5-100.5% (calc. to the dried substance), meets analytical specification of Ph. Eur., BP, USP
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Sodium fluoride, BioReagent, suitable for insect cell culture, ≥99%