Sodium fluoride PET/CT changes management of foot pain patients

Tuesday, December 1 | 3:20 p.m.-3:30 p.m. | SSJ19-03 | Room S505AB
In this scientific session presentation, researchers from Switzerland will discuss how F-18 sodium fluoride (F-18 NaF) PET/CT has the potential to help manage patients with persistent foot pain due to detection of unsuspected active osseous changes.

Over the course of two years, researchers from the University Hospital Zurich studied approximately 300 patients with joint disease, bones disease, and metastatic and benign lesions. That population was culled to 23 cases for the prospective study.

Thirty minutes prior to PET/CT scan, patients received 97-303 MBq of F-18 NaF administered intravenously. Patients were imaged in supine position on a combined PET/CT system (Discovery ST, GE Healthcare, Chalfont St. Giles, U.K.), and 3D-PET emission data were acquired for five minutes per bed position, including ankles and feet. Data were reconstructed with an iterative reconstruction algorithm using low-dose CT data for attenuation correction. Dedicated thin-slice CT imaging also was acquired in the same region.

In eight of the 23 patients, therapeutic management was changed due to uptake in previously unsuspected joints. F-18 NaF "gives indirect information of increased metabolic activity that can be inflammation and helps to show structure alterations," said lead author Dr. Dorothee Fischer, a radiologist in the university's department of nuclear medicine.

"With the additional information, therapy is more focused to target active areas or restrain from therapy where there is no activity, or they could do surgery on a specific area," she added. "There are many joints in the foot that it helps with the focus or the localization."

The researchers plan to investigate other musculoskeletal issues, especially benign lesions, with F-18 NaF PET/CT. They also have an ongoing study with patients who have undergone spinal surgery.

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