Early Evaluation of Inflammatory Focus and Treatment Response Using ¹⁸F-Sodium Fluoride Bone Positron Emission Tomography/Computed Tomography in Patients with Metallic Implants: A Case Report

We report a case of a 76-year-old woman with elevated serum C-reactive protein levels for two weeks after spinal surgery. ⁹⁹mTc-labeled white blood cell scan and dual ¹⁸F-sodium-fluoride (¹⁸F-NaF) bone positron emission tomography/computed tomography (PET/CT) were used to detect the site of inflammation. Using non-attenuation corrected images, soft tissue inflammation was detected without metal artifact. Antibiotic treatment attenuated inflammation as seen in an early-phase scan using follow-up ¹⁸F-NaF bone PET/CT. This case demonstrates the role of ¹⁸F-NaF bone PET/CT in the detection of inflammation sites, and can be used to evaluate treatment response in patients with metallic implants.