Role of Sodium Fluoride-PET in Primary Bone Tumors

  • Vivek Subbiah
  • Kalevi Kairemo
Part of the Clinicians’ Guides to Radionuclide Hybrid Imaging book series (CGRHI)


Malignant bone tumors are classified based on the histological origin. The nomenclature is based on the predominant components of the malignancy. Osteogenic sarcoma (osteosarcoma), chondrosarcoma, and Ewing’s sarcoma are primary bone tumors. Although multiple myeloma is the most common primary bone tumor it is considered a marrow cell tumor and not one arising from the bone. The incidence of the primary bone tumors vary depending upon the age (Table 9.1). Owing to the ability to metastasize and progress rapidly they are a cause of major morbidity and mortality. Osteosarcoma and Ewing’s sarcoma strike adolescents and young adults in the prime of their lives. Conventional imaging modalities for staging and restaging include bone scintigraphy with SPECT/CT, CT scan, MRI, and PET/CT scan. More recently sodium fluoride PET/CT scan has become available. The benefit of using sodium fluoride PET/CT in malignant primary bone tumors is characterized by detectable bone formation in soft-tissue. Herein, we discuss the role of sodium fluoride PET/CT scan in imaging of primary bone tumors specifically osteosarcoma and giant cell tumor of the bone. We also present the role of sodium fluoride PET/CT in staging, monitoring, and evaluation of response in malignant primary bone tumors.


Na18F PET 18F-FDG PET Bone scintigraphy 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Vivek Subbiah
    • 1
  • Kalevi Kairemo
    • 2
    • 3
  1. 1.Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Unit 455, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Nuclear Medicine and Molecular RadiotherapyDocrates Cancer CenterHelsinkiFinland
  3. 3.Department of Nuclear MedicineUniversity of Texas MD Anderson Cancer CenterHoustonUSA

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