18F-Sodium Fluoride PET–CT for the Assessment of Brain Metastasis from Lung Adenocarcinoma Stefania Gori, MD, Alessandro Inno, MD, PhD, Gianluigi Lunardi,

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18F-Sodium Fluoride PET–CT for the Assessment of Brain Metastasis from Lung Adenocarcinoma Stefania Gori, MD, Alessandro Inno, MD, PhD, Gianluigi Lunardi, PharmD, Giancarlo Gorgoni, PharmD, Veronica Malfatti, MD, Fabrizia Severi, ScD, Filippo Alongi, MD, Giovanni Carbognin, MD, Luigi Romano, MD, Stefano Pasetto, ScD, Matteo Salgarello, MD, PhD Journal of Thoracic Oncology Volume 10, Issue 8, Pages e67-e68 (August 2015) DOI: 10.1097/JTO.0000000000000523 Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Imaging of brain metastasis before starting systemic therapy. A, Brain MRI showing 12 mm right parietal metastasis with surrounding edema. B, 18F-NaF PET-CT with right parietal brain metastasis uptake 5 minutes after tracer injection; at that time, 18F-NaF is also detectable in the bloodstream within dural venous sinuses. C, 18F-NaF PET-CT 30 minutes after tracer injection; at that time, 18F-NaF is mainly uptaken by cranial bones, but residual uptake of brain metastasis is still detectable. MRI, magnetic resonance imaging; NaF, sodium fluoride; PET–CT, positron emission tomography–computed tomography. Journal of Thoracic Oncology 2015 10, e67-e68DOI: (10.1097/JTO.0000000000000523) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Imaging of brain metastasis after two cycles of cisplatin and pemetrexed. A, Brain MRI showing right parietal metastasis, decreased in size when compared with baseline (9 vs 12 mm, see Fig. 1). B, 18F-NaF PET-CT performed 5 minutes after tracer injection; the uptake intensity of brain metastasis has decreased from baseline: SUVmax from 4.20 to 2.40 (see Fig. 1). C, 18F-NaF PET-CT 30 minutes after tracer injection. MRI, magnetic resonance imaging; NaF, sodium fluoride; PET–CT, positron emission tomography–computed tomography. Journal of Thoracic Oncology 2015 10, e67-e68DOI: (10.1097/JTO.0000000000000523) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions