NOPR Registry

The PET imaging team at the S. Mark Taper Foundation Imaging Center, a division of Cedars-Sinai, is pleased to announce that we have expanded our services to include NaF18 (Sodium Fluoride) PET bone scanning for your Medicare oncology patients.

NaF18-PET has desirable characteristics as a bone-imaging agent, producing superior quality images in 45-60 minutes. NaF18-PET’s ability to demonstrate variation in bone matrix and the PET/CT scanner’s high resolution, tomographic skeletal images offer improved sensitivity compared to traditional Nuclear Medicine SPECT or planar bone imaging.1 In addition, the ability to scan the entire skeleton tomographically makes this modality beneficial in diagnosing a wide range of bone disorders. For many patients, NaF18-PET bone scans present a desirable alternative to conventional MDP bone scans.

The reported benefits of NaF18-PET bone scanning include:

  • Rapid whole body tomographic 3-D imaging
  • Higher accuracy in detecting both osteolytic and osteoblastic metastases2
  • Greater differentiation of benign versus malignant lesions3
  • Improved ability to identify the presence and the extent of bony metastases4
  • Rapid blood pool clearance1 allows significant reduction of injection-to-scan time
  • Similar dosimetry to 99mTc MDP1

NaF18-PET has been determined by the FDA to be safe and effective as a bone imaging agent to define areas of altered osteogenic activity. In early 2011, the National Oncologic PET Registry (NOPR) launched a Coverage with Evidence Development (CED) Study for NaF18-PET. The goals of NOPR NaF18-PET are to:

  • Provide access to NaF18-PET bone for patients with cancer
  • Eliminate the financial responsibility for patients
  • Generate evidence of reasonable quality to assist CMS in deciding whether to expand coverage of PET to include NaF18 imaging of bone

Medicare patients suspected of having primary or metastatic cancer are eligible to participate in the NOPR registry, under which CMS will cover NaF18-PET bone scans. Patients having NaF18-PET bone scans performed as part of a clinical trial approved by CMS may not be registered in NOPR.

CMS’ coverage decision through the NOPR registry offers eligible patients the opportunity for NaF18-PET bone scans as an alternative to conventional bone scans.

For more information about participation in the NOPR NaF18-PET bone registry, and to review the NOPR registry process, please contact Rene Siegel, Clinical Imaging Research and NOPR Administrator, at 310-423-3398 or

As always, I look forward to serving you and your patients.


Alan Waxman, MD
Co-Chair, Department of Imaging
Chief, Nuclear Medicine