Imaging with sodium fluoride can change treatment

Positron emission tomography (PET) imaging with sodium fluoride (NaF) changed treatment in about half of men with prostate cancer and could prove to be a better tool than bone scintigraphy, according to an analysis from the National Oncologic PET Registry (NOPR) published online Feb. 27, 2015 in the Journal of Nuclear Medicine.

As an NOPR participant, Scottsdale Medical Imaging (SMIL) has been contributing NaF PET data to the NOPR data set for several years. Over that time, Nishant Verma, MD, nuclear medicine oncologist at SMIL has become a proponent of NaF PET.

The study showed the overall frequency of change from nontreatment to treatment or vice versa was 46.7 percent for initial staging, 44.1 percent for suspected first osseous metastasis, and 52 percent for suspected progression of osseous metastasis.

“If someone has prostate cancer and evidence of progression, the first thing to look for is bone metastases, which is why sodium fluoride is the study you want to pick first,” Verma says. He says the advantage for the referring physician is that the diagnosis will be more accurate. And for the patient, there’s an advantage people often don’t talk about: Instead of the five or six hours it
takes for a conventional bone scan, the NaF PET takes about an hour and a half. “It is significantly faster, and significantly better,” Verma says. •

REFERENCE:
Hillner B, Siegel B, Hanna L, et al. Impact of 18F-Fluoride PET in patients with known prostate
cancer: initial results from the national oncologic PET registry. J Nucl Med. 2014; 55:574–581.