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Evaluation of neck pain with 18F-NaF PET/CT

Byrnes, Tiernan J.D.a; Xie, Wanyingb; Al-Mukhailed, Omarb; D’Sa, Anthonyb; Novruzov, Fuadb; Casey, Adrian T.H.a; House, Charlesc; Bomanji, Jamshed B.b

Nuclear Medicine Communications: March 2014 - Volume 35 - Issue 3 - p 298–302
doi: 10.1097/MNM.0000000000000044
Original Articles

Aim 18F-Sodium fluoride (18F-NaF) PET/computed tomography (CT) has improved spatial resolution in the cervical spine compared with single photon emission computed tomography/CT techniques using traditional tracers. Limited data are available, however, on its effectiveness in the management of the symptomatic cervical spine, and the aim of this study was therefore to elucidate this issue.

Patients and methods A retrospective study was carried out between April 2011 and April 2012. Across this period, 66 patients were referred to the department for the assessment of neck pain, of whom 58 were included in the study. 18F-NaF was used as the tracer and images were acquired on an integrated PET/CT scanner. All studies were evaluated by either consultant nuclear medicine physicians or by a radiologist. Two consultant neurosurgeons correlated the imaging reports with the clinical data from the patient notes to give an overall impression as to how beneficial the test had been with regard to patient management.

Results In 49/58 (84.5%) cases, the 18F-NaF PET/CT report was thought to have been clinically useful in patient management. In 9/58 (15.5%) cases, the report was thought not to have been clinically beneficial, generally because of high background vertebral uptake of 18F-fluoride secondary to degenerative disease.

Conclusion As our experience with 18F-NaF PET/CT broadens, we believe that it will become an increasingly important tool in the evaluation and management of the symptomatic cervical spine.

aThe National Hospital for Neurology and Neurosurgery

bInstitute of Nuclear Medicine

cDepartment of Radiology, University College London Hospitals NHS Trust, London, UK

Correspondence to Jamshed B. Bomanji, MBBS, PhD, FRCR, FRCP, Institute of Nuclear Medicine, T5, University College Hospital Hospitals NHS Trust, 235 Euston Road, London NW1 2BU, UK Tel: +44 203 447 0528; fax: +44 203 447 0596; e-mail:

Received September 13, 2013

Accepted October 18, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins