In previous studies in our institution, we demonstrated we could quantify 18F-NaF uptake in the aortic valve and that there was a progressive rise in activity with increasing disease severity. We found that at At 1 year, the baseline 18F-NaF uptake emerged as a powerful predictor of the progression in aortic valve calcification. Following analysis of 2 year follow up data, 18F-NaF emerged as an independent predictor of aortic valve replacement and cardiovascular mortality