[ 18 F] Sodium Fluoride Dose Reduction Enabled by Digital Photon Counting PET/CT for Evaluation of Osteoblastic Activity

The aim of the study was to assess the quality and reproducibility of reducing the injected [ F] sodium fluoride ([ F]NaF) dose while maintaining diagnostic imaging quality in bone imaging in a preclinical skeletal model using digital photon counting PET (dPET) detector technology. Beagles ( = 9) were administered three different [ F]NaF doses: 111 MBq ( = 5), 20 MBq ( = 5), and 1.9 MBq ( = 9). Imaging started ≃45 min post-injection for ≃30 min total acquisition time. Images were reconstructed using Time-of-Flight, ultra-high definition (voxel size of 1 × 1 × 1 mm ), with 3 iterations and 3 subsets. Point spread function was modeled and Gaussian filtering was applied. Skeleton qualitative and quantitative molecular image assessment was performed. The overall diagnostic quality of all images scored excellent (61%) and acceptable (39%) by all the reviewers. [ F]NaF SUV showed no statistically significant differences among the three doses in any of the region of interest assessed. This study demonstrated that a 60-fold [ F]NaF dose reduction was not significantly different from the highest dose, and it had not significant effect on overall image quality and quantitative accuracy. In the future, ultra-low dose [ F]NaF dPET/CT imaging may significantly decrease PET radiation exposure to preclinical subjects and personnel.