Technical feasibility, radiation dosimetry and clinical use of F-18-sodium fluoride (NaF) in evaluation of metastatic bone disease in pediatric population

摘要

PurposeThe role of F-18-fluoride (F-18-NaF) PET-CT for the detection of bone metastases in adults is well established and is considered superior to conventional bone scintigraphy. However, data pertaining use of F-18-NaF PET-CT in pediatric oncology is relatively sparse. The aim of the present study is to retrospectively analyze and share a single-center experience of F-18-NaF PET-CT in pediatric population and to provide preliminary information regarding imaging technique, feasibility of this modality in young patients and radiation dosimetry measurements in pediatric oncology cases.Materials and methodsTwenty-four pediatric patients (mean age 8.03.9) were included in the study for retrospective analysis. All patients were referred for primary staging or restaging for potential osseous metastatic disease and PET-CT scan was performed by injecting 2.2MBq/kg (0.06mCi/kg) of F-18-NaF.ResultsNine patients were imaged for primary staging and in all cases increase osteoblastic activity was seen in the primary tumor and of these, metastatic bone disease was identified in 2/9 patients. In the restaging group comprising 15/24 patients, metastatic deposits were identified in 3/15 whilst no disease was seen in the remaining 12 patients. Patients were injected a mean dose of 90.35 +/- 22.9MBq with an estimated mean effective absorbed doses of 2.98 +/- 0.75mSv for F-18-NaF and 3.37 +/- 2.4mSv for CT alone. Mean cumulative effective dose of F-18-NaF PET-CT scan was 5.11 +/- 2.7mSv.Conclusions F-18-NaF PET-CT may be a feasible alternative to Tc-99m MDP for radionuclide bone scintigraphy in the evaluation of pediatric bone pathology. Due to its better pharmacokinetics, there is potential that osseous staging can be achieved with relatively low doses and with a similar radiation burden as with Tc-99m-MDP imaging.