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18F-NaF PET/CT and Extraordinary Involvement: Non-calcific Brain Involvement in a Prostate Cancer Case


  • Ulku Korkmaz
  • Funda Ustun

Received Date: 29.06.2018 Accepted Date: 07.07.2019 Mol Imaging Radionucl Ther 2020;29(1):41-44 PMID: 32079388

With the increase in the diagnosis of the cancer, the frequency of using imaging methods for diagnosis and for staging is also increased. Because of the complex structure of cancer and tumor behavior, the assessment methods have been updated and metabolic imaging has gained weight. The most popular of these techniques is hybrid positron emission tomography/computed tomography (PET/CT) systems. Prostate cancer is the second most common cancer in the world, is the fifth common type in cancer-related male deaths. Estimation of prognosis and treatment planning of the patients are based on the TNM classification. Bone metastasis is a prognostic factor of morbidity and mortality in prostate cancer. Sodium fluoride (NaF) PET/CT is a promising imaging modality in evaluation of skeletal system. This article will review the involvement of 18F-NaF in extra-osseous tissues in the prostate cancer and reveal the fundamental differences between 18F-NaF imaging and 18F-FDG imaging in these areas.

Keywords: NaF, PET, brain, metastasis


Informed Consent: Written informed consent of the patient was obtained from patient.

Peer-review: Externally peer-reviewed.

Authorship Contributions

Concept: F.U., Design: U.K., F.U., Data collection or processing: U.K., Analysis or interpretation: U.K., F.U., Literature search: U.K., Writing: U.K.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial support.


  1. Rubens RD: bone metastases incidence and complications. In cancer and the skeleton. Edited by: Rubens RD, Mundy GR. London: Martin Dunitz; 2000:33-42.
  2. Cook G, Parker C, Chua S, Johnson B, Aksnes AK, Lewington VJ. 18F-fluoride PET: changes in uptake as a method to assess response in bone metastases from castrate-resistant prostate cancer patients treated with 223Ra-chloride (Alpharadin), EJNMMI Research 2011; 1:4.
  3. Installe J, Nzeusseu A, Bol A, Depresseux G, Devogelaer JP, Lonneux M. 18F-Fluoride PET for Monitoring Therapeutic Response in Paget’s Disease of Bone. J Nucl Med 2005;46:1650-1658.
  4. Araz M, Aras G, Küçük ÖN. The role of 18F-NaF PET/CTin metastatic bone disease. J Bone Oncol 2015;4:92-97.
  5. Oldan JD, Hawkins AS, Chin BB. 18F Sodium Fluoride PET/CT in Patients with Prostate Cancer: Quantification of Normal Tissues, Benign Degenerative Lesions, and Malignant Lesions. World J Nucl Med 2016;15:102-108.
  6. Fortin D. The blood-brain barrier: its influence in the treatment of brain tumors metastases. Curr Cancer Drug Targets 2012;12:247-259.
  7. Worsley DF, Lentle BC: Uptake of technetium-99mMDP in primary amyloidosis with are view of the mechanisms of soft tissue localization of bone seeking radiopharmaceuticals. JNuclMed 1993;34:1612-1615.
  8. Wissenbach U, Niemeyer BA, Fixemer T, Schneidewind A, Trost C, Cavalie´ A, Reus K, Meese E, Bonkhoff H, Flockerzi V. Expression of CaT-like, a Novel Calcium-selective Channel, Correlates with the Malignancy of Prostate Cancer. J Biol Chem 2011;276:19461-19468.