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Fluorine F 18 sodium fluoride + fludeoxyglucose F-18 is a dual-tracer radiopharmaceutical combination used for diagnostic imaging via positron emission tomography (PET). Fluorine F 18 sodium fluoride (NaF) acts as a bone-seeking agent, depositing in the hydroxyapatite matrix of bone, particularly in areas of active remodeling such as osteoblastic metastases. Fludeoxyglucose F 18 (FDG) is a glucose analog that is taken up by cells with high metabolic rates, such as malignant tumors, and is trapped intracellularly after phosphorylation. This combination is being investigated by Stanford University in a "one-stop-shop" PET/MRI protocol to evaluate treatment response in patients with metastatic castration-resistant prostate cancer (mCRPC), specifically those receiving radium Ra 223 dichloride (Xofigo), by providing a comprehensive view of both metabolic and structural disease activity.
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