Sodium 18F-Fluoride Bone Scintigraphy in Deep Ocean Diver.

Area of Science:

• Nuclear medicine
• Radiopharmaceutical imaging
• Bone metabolism

Background:

• Sodium ¹⁸F-fluoride (NaF) was an early radiotracer for bone scintigraphy, approved by the US FDA in 1972.
• Its use was discontinued in 1984, with newer agents like Technetium-99m-based tracers becoming standard.
• Bone scintigraphy is crucial for evaluating bone formation and detecting abnormalities like infarcts.

Observation:

• A US naval officer experienced prolonged exposure to an undersea environment (oceanic lab, 205 feet below surface).
• Four years post-exposure, skeletal films revealed bilateral femoral bone infarcts.
• A historical rectilinear scan using Sodium ¹⁸F-fluoride (NaF) was performed for diagnostic evaluation.

Findings:

• The Sodium ¹⁸F-fluoride (NaF) bone scintigraphy demonstrated low-normal to decreased tracer uptake in the affected femoral regions.
• This finding contrasts with the expected increased tracer activity typically seen in areas of active bone formation or repair.
• The case provides a unique historical example of NaF scintigraphy in the context of bone infarcts.

Implications:

• This case illustrates a historical application of Sodium ¹⁸F-fluoride (NaF) in evaluating bone pathology.
• The observed decreased tracer activity in bone infarcts warrants consideration when interpreting historical NaF scans.
• Discussion of past and present bone scintigraphic radiotracers provides context for evolving diagnostic imaging techniques.