Assessment of the metabolic activity of bone grafts with 18F-fluoride PET

Brenner, Winfried; Vernon, Cheryl; Conrad, Ernest U.; Eary, Janet F.

doi:10.1007/s00259-004-1568-z

Cited by 36 publications

(16 citation statements)

References 15 publications

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“…Other preliminary studies have successfully utilized 18 F-fluoride PET to evaluate the incorporation of bone graft in total hip arthroplasty, bone turnover in Paget's disease, and bone healing potential in women with osteoporosis [31,45,69,70], realizing the advantages of a noninvasive imaging method to assess real-time osteoblastic activity. Consequently, PET scans may ultimately help predict the development of a nonunion at an earlier time point than current routine imaging techniques.…”

Section: Discussionmentioning

confidence: 99%

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

Hsu

Feeley

Krenek

et al. 2007

Eur J Nucl Med Mol Imaging

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Purpose-Currently available diagnostic techniques can be unreliable in the diagnosis of delayed fracture healing in certain clinical situations, which can lead to increased complication rates and costs to the health care system. This study sought to determine the utility of positron emission tomography (PET) scanning with 18 F-fluoride ion, which localizes in regions of high osteoblastic activity, and 18 F-fluorodeoxyglucose (FDG), an indicator of cellular glucose metabolism, in assessing bone healing in a rat femur fracture model. Methods-Fractureswere created in the femurs of immuno-competent rats. Animals in group I had a fracture produced via a manual three-point bending technique. Group II animals underwent a femoral osteotomy with placement of a 2-mm silastic spacer at the fracture site. Fracture healing was assessed with plain radiographs, 18 F-fluoride, and 18 F-FDG PET scans at 1, 2, 3, and 4-week time points after surgery. Femoral specimens were harvested for histologic analysis and manual testing of torsional and bending strength 4 weeks after surgery.Results-All fractures in group I revealed abundant callus formation and bone healing, while none of the nonunion femurs were healed via assessment with manual palpation, radiographic, and histologic evaluation at the 4-week time point. 18 F-fluoride PET images of group I femurs at successive 1-week intervals revealed progressively increased signal uptake at the union site during fracture repair. In contrast, minimal tracer uptake was seen at the fracture sites in group II at all time points after surgery. Data analysis revealed statistically significant differences in mean signal intensity between groups I and II at each weekly interval. No significant differences between the two groups were seen using 18 F-FDG PET imaging at any time point.Conclusion-This study suggests that 18 F-fluoride PET imaging, which is an indicator of osteoblastic activity in vivo, can identify fracture nonunions at an early time point and may have a role in the assessment of longitudinal fracture healing. PET scans using 18 F-FDG were not helpful in differentiating metabolic activity between successful and delayed bone healing.

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Section: Discussionmentioning

confidence: 99%

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

Hsu

Feeley

Krenek

et al. 2007

Eur J Nucl Med Mol Imaging

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“…In contrast to 3-phase bone scans, 18 F-NaF PET allows quantitative measurements of bone blood flow and metabolism (43). Figure 4 demonstrates a case of a vascularized fibula graft after resection of a primary osteosarcoma of the femur shaft.…”

Section: Bone Viabilitymentioning

confidence: 99%

Dynamic Bone Imaging with^99mTc-Labeled Diphosphonates and¹⁸F-NaF: Mechanisms and Applications

2013

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Learning Objectives: On successful completion of this activity, participants should be able to (1) appreciate the physiologic mechanisms underlying uptake of bone-seeking radiopharmaceuticals used to assess bone perfusion and turnover and note the differences between 18 F-NaF and 99m Tc-labeled diphosphonates; (2) discuss the use of bone scintigraphy for evaluation of bone viability and metabolic bone disorders and appreciate the potential role of quantitative dynamic 18 F-NaF PET for evaluation of response to therapy; and (3) discuss indications for 99m Tc-labeled diphosphonate bone scans and 18 F-NaF PET/CT for oncologic staging and appreciate quantitative methods on static and dynamic bone imaging as imaging biomarkers of treatment response using novel systemic therapies for metastatic castrate-resistant prostate cancer as a model.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, participants can access this activity through the SNMMI Web site (http:// www.snmmi.org/ce_online) through April 2016.Dynamic bone scanning with 99m Tc-labeled diphosphonates and 18 F-labeled sodium fluoride provides functional information sensitive for subtle changes in bone turnover and perfusion, which assists the clinical management of numerous osseous pathologies. This article reviews the mechanisms of uptake of 99m Tc-labeled diphosphonates and 18 F-sodium fluoride and discusses and compares the performance of these bone-seeking radiotracers for clinical and research applications, using dynamic and multiple-time-point imaging protocols and quantitative techniques.

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“…It has also been shown that planar bone scintigraphy has a significantly lower accuracy in detecting bone metastases than has combined bone scintigraphy and single-photon emission computed tomography (SPECT) or [ [3,9,10], few studies are available that have defined the role of static [ 18 F]fluoride PET/(CT) for the evaluation of non-malignant bone disorders [3,[11][12][13][14]. Recently promising results of SPECT/CT imaging in patients with foot pain have been published [15,16].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

et al. 2010

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Purpose To evaluate the therapeutic impact of [18 F]fluoride positron-emission tomography/computed tomography ([ 18 F]fluoride PET/CT) imaging on patients with unclear foot pain. Methods Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [18 F] fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging. Results In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; nonconsolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images. Conclusion [18 F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pain.

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Assessment of the metabolic activity of bone grafts with 18F-fluoride PET

Abstract: Quantitative (18)F-fluoride PET is a promising tool for assessment of fluoride metabolism and normal healing in bone grafts of the limbs.

Cited by 36 publications

References 15 publications

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

Dynamic Bone Imaging with^99mTc-Labeled Diphosphonates and¹⁸F-NaF: Mechanisms and Applications

Therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

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Assessment of the metabolic activity of bone grafts with 18F-fluoride PET

Abstract: Quantitative (18)F-fluoride PET is a promising tool for assessment of fluoride metabolism and normal healing in bone grafts of the limbs.

Cited by 36 publications

References 15 publications

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

Dynamic Bone Imaging with99mTc-Labeled Diphosphonates and18F-NaF: Mechanisms and Applications

Therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

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Dynamic Bone Imaging with^99mTc-Labeled Diphosphonates and¹⁸F-NaF: Mechanisms and Applications