Molecular imaging of dural microcalcification: Detection of active mineralization with ¹⁸F-NaF PET/CT

Dural calcification is frequently observed on computed tomography (CT) as an age-associated finding, yet its biological activity and potential for pathological progression remain poorly characterized. Fluorine-18-sodium fluoride (¹⁸F-NaF) is a positron emission tomography (PET) radiotracer that can detect biologically active microcalcification and may thus enable monitoring of such lesions. We describe a 73-year-old woman with hypertension, hypercholesterolemia, and atrial fibrillation who was incidentally found to have focal ¹⁸F-NaF uptake in the falx cerebri (mean standardized uptake value (SUVmean) 1.29, SUVmax 2.02) and tentorium cerebelli (SUVmean 1.08, SUVmax 1.76). This case highlights the novel capability of ¹⁸F-NaF PET to characterize dural mineralization at the molecular level and serve as a biomarker of lesion progression.