18F-Sodium Fluoride PET/CT in Oncology An Atlas of SUVs

Purpose: The purpose of this study was to analyze the distribution of F-18 Sodium Fluoride (F-18-NaF) uptake in the normal skeleton, benign and malignant bone lesions, and extraskeletal tissues, using semiquantitative SUV measurements. Patients and Methods: We retrospectively analyzed data from 129 patients who had F-18-NaF PET/CT at our institution for an oncological diagnosis between 2007 and 2014. There were 99 men and 30 women, 19 to 90 years old (mean [SD], 61.5 [15.5]). The range, average, and SD of SUV were measured for normal bone and extraskeletal tissues uptake for the entire patient population. A separate statistical analysis was performed to compare group A, which corresponds to the population of patient with no F-18-NaF-avid metastatic lesions, and group B, which corresponds to the population of patient with F-18-NaF-avid metastatic lesions. We also measured SUVmax and SUVmean for bony metastases and degenerative changes Results: The PET/CT images were acquired at 30 to 169 minutes (mean [SD], 76.5 [22.8]) after injection of 3.9 to 13.6 mCi (mean [SD], 7.3 [2.4]) of F-18-NaF. The range and mean (SD) of SUVmax for F-18-NaF-avid metastasis were 4.5 to 103.3 and 25.9 (16.6) and for F-18-NaF-avid degenerative changes were 3.3 to 52.1 and 16.5 (7.9), respectively. Conclusions: Various skeletal sites have different normal SUVs. Skeletal metastases have different SUVs when compared with benign findings such as degenerative changes.