Abstract

18F-sodium fluoride (18F-NaF) is a positron emission tomography (PET) radiotracer widely used in skeletal imaging and has also been proposed as a biomarker of active calcification in atherosclerosis. Like most PET radiotracers, 18F-NaF is typically administered intravenously. However in small animal research intravenous administrations can be challenging, because partial paravenous injection is common due to the small calibre of the superficial tail veins and repeat administrations via tail veins can lead to tissue injury therefore limiting the total number of longitudinal scanning points. In this paper, the feasibility of using intra-peritoneal route of injection of 8F-NaF to study calcification in mice was studied by looking at the kinetic and uptake profiles of normal soft tissues and bones versus intra-vascular injections. Dynamic PET was performed for 60 min on nineteen isoflurane-anesthetized male Swiss mice after femoral artery (n = 7), femoral vein (n = 6) or intraperitoneal (n = 6) injection of 8F-NaF. PET data were reconstructed and the standardised uptake value (SUV) and standardised uptake value ratio (SUVr) were estimated from the last three frames between 45- and 60-min and 8F-NaF uptake constant (Ki) was derived by Patlak graphical analysis. In soft tissue, the 18F-NaF perfusion phase changes depending on the type on injection route, whereas the uptake phase is similar regardless of the administration route. In bone tissue SUV, SUVr and Ki measures were not significantly different between the three administration routes. Comparison between PET and CT measures showed that bones that had the highest CT density displayed the lowest PET activity and conversely, bones where CT units were low had high 8F-NaF uptake. Intraperitoneal injection is a valid and practical alternative to the intra-vascular injections in small-animal 18F-NaF PET imaging providing equivalent pharmacokinetic data. CT outcome measures report on sites of stablished calcification whereas PET measures sites of higher complexity and active calcification.

Highlights

  • 18F-sodium fluoride (18F-NaF) is a positron emission tomography (PET) radiotracer widely used in skeletal imaging and has been proposed as a biomarker of active calcification in atherosclerosis

  • The short lived radioactive tracer 18F-sodium fluoride (18F-NaF) is a positron-emitting radiotracer widely used in skeletal imaging since the 1960s due to its high affinity for bone hydroxyapatite ­matrix1. 18F-NaF has minimal protein binding allowing for fast soft-tissue clearance where nearly half of the injected radiotracer is taken up by the bones immediately after i­njection[2,3]

  • The use of 18F-NaF for bone metastasis imaging was fuelled by the development and installation of the first clinical Positron Emission Tomography/Computed Tomography (PET/CT) scanner, allowing high-resolution functional imaging with significantly greater sensitivity, specificity, and accuracy than conventional planar bone scintigraphy with b­ isphosphonates[9,10]

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Summary

Introduction

18F-sodium fluoride (18F-NaF) is a positron emission tomography (PET) radiotracer widely used in skeletal imaging and has been proposed as a biomarker of active calcification in atherosclerosis. The use of 18F-NaF for bone metastasis imaging was fuelled by the development and installation of the first clinical Positron Emission Tomography/Computed Tomography (PET/CT) scanner, allowing high-resolution functional imaging with significantly greater sensitivity, specificity, and accuracy than conventional planar bone scintigraphy with b­ isphosphonates[9,10]. This old PET radiotracer has been re-purposed as a biomarker of active calcification in coronary a­ therosclerosis[11,12], an unfavourable event in the history of atherosclerosis that predicts cardiovascular morbidity and ­mortality[13]. Reproducible intravenous injection is not always possible for longitudinal studies or for sequential or multipletracer injection studies due to residual activity from previous i­njections[32,33]

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