Response to: Letter to the Editors: Re: Simultaneous PET/MRI in the Evaluation of Breast and Prostate Cancer Using Combined Na[18F]F and [18F]FDG: A Focus on Skeletal Lesions

  • Ida Sonni
  • Ryogo Minamimoto
  • Lucia Baratto
  • Andrei IagaruEmail author
Letter to the Editor



We thank Dr. Høilund-Carlsen and Dr. Alavi for their interest in our article [1]. The authors wrote that the combined Na[18F]F/[18F]FDG PET/MRI approach used in our study can be an overkill causing more confusion than clarity [2]. The reason for this confusion seems to be the high sensitivity of Na[18F]F, which may identify cancer-like foci in case of microcalcification caused by other conditions than malignancy. The authors reference two case reports to support their argument [3, 4]; Na[18F]F uptake was described in both of their cases in noncancerous calcifications of the tracheobronchial tree and of a uterine leiomyoma, respectively.

Funding Information

AI receives institutional grants from GE Healthcare, Advanced Accelerator Applications, and Progenics Pharmaceuticals.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Sonni I, Minamimoto R, Baratto L, Gambhir SS, Loening AM, Vasanawala SS, Iagaru A (2019) Simultaneous PET/MRI in the evaluation of breast and prostate cancer using combined Na[18F] F and [18F]FDG: a focus on skeletal lesions. Mol Imaging Biol doi:1–10.
  2. 2.
    Hoilund-Carlsen PF, Alavi A (2019) Letter to the editor: simultaneous PET/MRI in the evaluation of breast and prostate cancer using combined Na[18F] F and [18F]FDG: a focus on skeletal lesions. Mol Imaging Biol doi:1–2.
  3. 3.
    Al-Zaghal A, Werner TJ, Hoilund-Carlsen PF, Alavi A (2018) Identification of tracheobronchial tree calcifications using molecular imaging probes: 18F-NaF PET/CT. Clin Nucl Med 43:e278–e2e9CrossRefGoogle Scholar
  4. 4.
    Al-Zaghal A, Werner TJ, Hoilund-Carlsen PF, Alavi A (2018) The detection of uterine leiomyoma (fibroid) calcifications on 18F-NaF PET/CT. Clin Nucl Med 43:e287–e2e8CrossRefGoogle Scholar
  5. 5.
    Iagaru A, Mittra E, Mosci C, Dick DW, Sathekge M, Prakash V, Iyer V, Lapa P, Isidoro J, de Lima JM, Gambhir SS (2013) Combined 18F-fluoride and 18F-FDG PET/CT scanning for evaluation of malignancy: results of an international multicenter trial. J Nucl Med 54:176–183CrossRefGoogle Scholar
  6. 6.
    Iagaru A, Young P, Mittra E, Dick DW, Herfkens R, Gambhir SS (2013) Pilot prospective evaluation of 99mTc-MDP scintigraphy, 18F NaF PET/CT, 18F FDG PET/CT and whole-body MRI for detection of skeletal metastases. Clin Nucl Med 38:e290–e296CrossRefGoogle Scholar

Copyright information

© World Molecular Imaging Society 2020

Authors and Affiliations

  1. 1.Division of Nuclear Medicine and Molecular Imaging, Department of RadiologyStanford UniversityStanfordUSA
  2. 2.Ahmanson Translational Theranostics Division, Department of Molecular and Medical PharmacologyDavid Geffen School of Medicine; University of California Los AngelesLos AngelesUSA

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