{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:36:53Z","timestamp":1791387413740,"version":"4.3.3"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Evaluation of bone healing potential in cases of delayed union or non-union remains a challenge. This study evaluated the use of [<jats:sup>18<\/jats:sup>F]NaF PET\/CT to assess bone healing and its role in guiding clinical decision-making in orthopaedic trauma surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>From June 2019 to December 2024, a prospective study was conducted in a level 1 trauma center. The study included 18 patients (20 fractures: 15 non-unions, 5 bone defects) all showing impaired bone healing after initial surgical fracture treatment, who were eligible for revision surgery. Dynamic (first 10\u00a0min post-tracer injection) and static (1-hour post-injection) [<jats:sup>18<\/jats:sup>F]NaF PET\/CT scans were performed to assess bone healing capacity through qualitative and quantitative analysis. The relationship between scan results and treatment outcome was evaluated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Increased [<jats:sup>18<\/jats:sup>F]NaF uptake, suggestive for bone healing capacity, was observed in all fractures (20\/20). Based on the positive [<jats:sup>18<\/jats:sup>F]NaF PET\/CT results, watchful waiting was recommended for all fractures, with two patients preferring surgery. After prolonged watchful waiting, 72% (13\/18) showed bone healing progression. Notably, atrophic fractures displayed biological activity, and non-unions demonstrated sustained metabolic activity even beyond 12 months. Most fractures requiring revision surgery (80%, 4\/5) needed additional stabilization. Ultimately, [<jats:sup>18<\/jats:sup>F]NaF PET\/CT imaging helped to avoid revision surgery in 65% of all fractures (13\/20). Uptake pattern analysis suggest that whole-bone uptake could potentially indicate surgical need (\u03c7\u00b2 = 5.62, <jats:italic>p<\/jats:italic>\u2009=\u20090.018). Quantitative assessment provided no additional information.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>[<jats:sup>18<\/jats:sup>F]NaF PET\/CT imaging provides valuable insights into bone healing potential, especially in non-unions, helping guide clinical decisions and reducing unnecessary surgeries. This study challenges traditional non-union definitions by highlighting the biological activity of both atrophic and hypertrophic fractures.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00259-025-07209-y","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T04:59:38Z","timestamp":1744347578000},"page":"3903-3914","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["[18F]NaF PET\/CT to assess bone healing capacity in orthopaedic trauma surgery: a feasibility study"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7132-9792","authenticated-orcid":false,"given":"N. D.","family":"van Rijsewijk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Wouthuyzen-Bakker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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Approval was granted by the local Medical Ethical Commission of the University Medical Center Groningen (METC number 2019\/00207).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The research position of Nick van Rijsewijk was funded through Partnership of UMCG-Siemens for building the future of Health (PUSH). The funder had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results. Other authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}