Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
J Nucl Med. 2012 Aug;53(8):1175-84. doi: 10.2967/jnumed.111.100883. Epub 2012 Jun 22.
We evaluated the kinetics of (18)F-sodium fluoride (NaF) and reassessed the recommended dose, optimal uptake period, and reproducibility using a current-generation PET/CT scanner.
In this prospective study, 73 patients (31 patients with multiple myeloma or myeloma precursor disease and 42 with prostate cancer) were injected with a mean administered dose of 141 MBq of (18)F-NaF. Sixty patients underwent 3 sequential sessions of 3-dimensional PET/CT of the torso beginning approximately 15 min after (18)F-NaF injection, followed by whole-body 3-dimensional PET/CT at 2 h. The remaining 13 prostate cancer patients were imaged only at 2 and 3 h after injection. Twenty-one prostate cancer patients underwent repeated baseline studies (mean interval, 5.9 d) to evaluate reproducibility.
The measured effective dose was 0.017 mSv/MBq, with the urinary bladder, osteogenic cells, and red marrow receiving the highest doses at 0.080, 0.077, and 0.028 mGy/MBq, respectively. Visual analysis showed that uptake in both normal and abnormal bone increased with time; however, the rate of increase decreased with time. A semiautomated workflow provided objective uptake parameters, including the mean standardized uptake value of all pixels within bone with SUVs greater than 10 and the average of the mean SUV of all malignant lesions identified by the algorithm. The values of these parameters for the images beginning at approximately 15 min and approximately 35 min were significantly different (0.3% change per minute). Differences between the later imaging time points were not significant (P < 0.01). Repeated baseline studies showed high intraclass correlations (>0.9) and relatively low critical percentage change (the value above which a change can be considered real) for these parameters. The tumor-to-normal bone ratio, based on the maximum SUV of identified malignant lesions, decreased with time; however, this difference was small, estimated at approximately 0.16%/min in the first hour.
(18)F-NaF PET/CT images obtained with modest radiation exposures can result in highly reproducible imaging parameters. Although the tumor-to-normal bone ratio decreases slightly with time, the high temporal dependence during uptake periods less than 30 min may limit accurate quantitation. An uptake period of 60 ± 30 min has limited temporal dependence while maintaining a high tumor-to-normal bone ratio.
我们评估了（18）F-氟化钠（NaF）的动力学，并使用当前一代的 PET/CT 扫描仪重新评估了推荐剂量、最佳摄取期和可重复性。
在这项前瞻性研究中，73 名患者（31 名多发性骨髓瘤或骨髓瘤前体疾病患者和 42 名前列腺癌患者）注射了平均 141MBq 的（18）F-NaF。60 名患者在注射（18）F-NaF 后约 15 分钟开始进行 3 次全身 3 维 PET/CT 扫描，然后进行 2 小时全身 3 维 PET/CT 扫描。其余 13 名前列腺癌患者仅在注射后 2 小时和 3 小时进行成像。21 名前列腺癌患者进行了重复的基线研究（平均间隔 5.9 天），以评估可重复性。
测量的有效剂量为 0.017mSv/MBq，尿液膀胱、成骨细胞和红骨髓分别接受了 0.080、0.077 和 0.028mGy/MBq 的最高剂量。视觉分析显示，正常和异常骨中的摄取随时间增加，但增加率随时间降低。半自动工作流程提供了客观的摄取参数，包括骨内所有像素的平均标准化摄取值（SUVs 大于 10）和算法识别的所有恶性病变的平均 SUV 平均值。大约 15 分钟和大约 35 分钟开始的图像的这些参数值差异显著（每分钟 0.3%的变化）。较晚的成像时间点之间的差异无统计学意义（P<0.01）。这些参数的重复基线研究显示出高组内相关性（>0.9）和相对较低的临界百分比变化（可以认为变化是真实的）。基于识别出的恶性病变的最大 SUV，肿瘤与正常骨的比值随时间降低；然而，这种差异很小，在第一个小时内估计为每分钟 0.16%。
适度辐射暴露下获得的（18）F-NaF PET/CT 图像可产生高度可重复的成像参数。尽管肿瘤与正常骨的比值随时间略有降低，但摄取期小于 30 分钟时的高时间依赖性可能限制准确的定量。60±30 分钟的摄取期在保持高肿瘤与正常骨比值的同时，具有有限的时间依赖性。
