• Manas Kumar Sahoo, Sellam Karunanithi, and Chandra Shekhar Bal.
• Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India, drmksahoo@gmail.com.
• Jpn J Radiol. 2013 Nov 1;31(11):766-9.

AbstractPulmonary alveolar microlithiasis (PAM) is a very rare disease in which multiple microscopic calcium phosphate microliths are deposited within the alveoli of both lungs. A lung biopsy is considered to be definitive for final diagnosis; however, non-invasive imaging modalities such as chest X-ray, HRCT scan and (99m)Tc-MDP bone scan suggest the diagnosis in the vast majority of patients. Although (18)F-FDG PET/CT has been tried to characterize the disease, (18)F-sodium fluoride PET/CT as a 'proof-of-principle' was tried for the first time in a known case of PAM in order to characterize the lung lesions. Interestingly, we noted that (18)F-sodium fluoride PET/CT is a superior modality in characterization and assessment of the extent of disease in PAM compared to all other non-invasive imaging modalities. Thus, we recommend that (18)F-sodium fluoride PET/CT should be the investigation of choice in PAM.

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