Fluorine-18 Sodium Fluoride: Applications and Advantages

Fluorine-18 Sodium Fluoride (18F-NaF) is an essential radiopharmaceutical agent in diagnostic medical imaging, primarily Positron Emission Tomography (PET). The unique properties of fluorine-18 (18F), a positron-emitting isotope of fluorine, combined with the biological affinity of sodium fluoride for bone minerals, make 18F-NaF a highly valuable tool for the detection and evaluation of various bone-related disorders.

Revolutionising Bone Imaging: The Evolution and Clinical Acceptance of 18F-NaF from the 1960s to Modern PET Scanners

18F-NaF as a bone imaging agent dates back to the early 1960s. However, it wasn’t until the 1990s, with the advent of modern PET scanners, that 18F-NaF gained widespread clinical acceptance. The increasing availability of PET scanners and cyclotrons, which produce 18F, has facilitated the development of 18F-NaF as a reliable diagnostic agent.

Production of 18F-NaF

18F-NaF is produced by bombarding 18O-enriched water with protons in a cyclotron, generating fluorine-18. The 18F isotope is then reacted with sodium chloride to produce 18F-NaF. The relatively short half-life of 18F, approximately 110 minutes, necessitates that the production and distribution of 18F-NaF be closely coordinated with clinical demand.


  • 18F-NaF PET/CT is extensively used to detect bone metastases, particularly in prostate, breast, and lung cancer patients. Compared to conventional bone scintigraphy, the high sensitivity and specificity of 18F-NaF PET/CT in detecting metastatic lesions result in improved diagnostic accuracy, earlier detection, and improved patient management.
  • 18F-NaF PET imaging provides a non-invasive means of assessing bone metabolism, thereby enabling the diagnosis and monitoring of osteoporosis. In addition, the technique offers insights into the pathophysiology of the disease and aids in evaluating treatment efficacy.
  • 18F-NaF PET/CT has proven useful in identifying active inflammation in musculoskeletal disorders.  For example, rheumatoid arthritis, spondyloarthropathies, and vasculitis. In addition, the high sensitivity of 18F-NaF PET/CT allows for the detection of subtle changes in bone metabolism, which can improve the management of these conditions.


  • High resolution: The combination of 18F-NaF and PET technology allows for high-resolution imaging, enabling the detection of small lesions and offering superior image quality compared to conventional bone scintigraphy.
  • Rapid uptake and clearance: 18F-NaF exhibits rapid bone uptake and quick clearance from soft tissues, resulting in high bone-to-background contrast and shorter imaging times.
  • Quantitative analysis: The PET technique allows for quantitative analysis of tracer uptake, providing valuable information on bone metabolism and evaluating treatment response.

Fluorine-18 Sodium Fluoride: Unleashing the Potential of Nuclear Medicine for Enhanced Bone Disease Diagnosis and Patient Care

Fluorine-18 Sodium Fluoride has emerged as a powerful diagnostic tool in nuclear medicine, with applications in detecting and assessing various bone-related diseases. In addition, its high sensitivity, specificity, and resolution, coupled with the advantages of PET technology, make it a valuable asset in clinical practice and patient care.

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