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Der Nuklearmediziner 2016; 39(01): 22-29
DOI: 10.1055/s-0042-101479
Neue Aspekte in der Diagnostik und Therapie von Skeletterkrankungen
© Georg Thieme Verlag KG Stuttgart · New York

F-18-Fluorid-Skelettdiagnostik mit PET, PET/CT und PET/MRT

Bone Scanning with F-18 Fluoride using PET, PET/CT or PET/MRI
G. Farmakis
1   Zentrum für Nuklearmedizin und PET/CT, Bremen
,
D. Hellwig
2   Abteilung für Nuklearmedizin, Universitätsklinikum Regensburg, Regensburg
› Author Affiliations
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Publication History

Publication Date:
22 March 2016 (online)

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Zusammenfassung

F-18-Natriumfluorid ist ein osteotropes Radiopharmakon für die szintigrafische Darstellung des Knochenstoffwechsels. Seine FDA-Zulassung erhielt das Radiopharmakon bereits im Jahr 1972. Die Entwicklung von Tc-99m-markierten osteotropen Substanzen sowie deren bessere Verfügbarkeit drängte Natriumfluorid zunehmend in den Hintergrund. Der Molybdänengpass ist jedoch bereits einmal zu einem Problem für die konventionelle Skelettszintigrafie geworden und wird dies wohl in Zukunft wieder. Durch die Entwicklung von modernen Hybridgeräten (PET/CT, PET/MR) erlaubt die Skelettdiagnostik mit F-18-Natriumfluorid des Weiteren eine viel sensitivere und spezifische Diagnostik als die spätstatische konventionelle Skelettszintigrafie und bringt daher diesen Tracer erneut in den Vordergrund. Wir zeigen hier Indikationen, Durchführung, Datenakquisition und -auswertung sowie Befundungskonzepte der Untersuchung. Ein Vergleich von Natriumfluorid mit der konventionellen Skelettszintigrafie wird ebenfalls bei den verschiedenen Indikationen vorgenommen.

Abstract

F-18 sodium fluoride is a bone-seeking agent for the scintigrafic imaging of bone metabolism. It was approved for clinical use by the US Food- and Drug-Administration (FDA) in 1972. The development of Tc-99m-based radiotracers for bone scintigrafy and their wide availability forced PET imaging with sodium fluoride to the background. However the global molybdenum shortage emerged to a huge problem for the conventional bone scintigrafy a few years ago and, as the problem has not been solved, we will be probably facing it again in the next years. Furthermore, the development of modern hybrid scanners (PET/CT, PET/MR) allows a higher diagnostic accuracy with sodium fluoride than the conventional bone scintigrafy and that is the reason for the rising interest for this tracer. In this article we will be focusing on indications, protocols, interpretation and reporting of sodium fluoride PET and perform a comparison between PET imaging and conventional bone scanning.

Schlüsselwörter

F-18 Natriumfluorid - PET - PET/CT - PET/MRT - Skelettszintigrafie

Key words

F-18 Fluoride - PET - PET/CT - PET/MRI - bone scanning
 

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