18F-NaF PET/CT for early detection of osteoporosis in the lumbar spine: two case reports

Osteoporosis is a highly prevalent skeletal disease involving a pathophysiology of altered bone turnover. Positron emission tomography (PET)/computed tomography (CT) imaging with ¹⁸F-sodium fluoride (NaF) can visualize metabolic alterations in bone that precede clinical manifestations or structural alterations and thus may serve a role in the early detection and monitoring of osteoporosis. We present two non-oncological case reports demonstrating different metabolic changes in early and advanced disease stages as assessed by ¹⁸F-NaF PET/CT that cannot be appreciated by conventional structural imaging alone, supporting a potential clinical application of ¹⁸F-NaF PET/CT for early detection and monitoring of osteoporosis in the lumbar spine.