Quantification of Skeletal Kinetic Indices in Paget's Disease Using Dynamic18F-Fluoride Positron Emission Tomography

Abstract

The purpose of this study was to quantify indices of regional bone metabolism in Paget's disease and to compare these indices with normal bone using dynamic

Long-Term Precision of 18F-Fluoride PET Skeletal Kinetic Studies in the Assessment of Bone Metabolism

“…18 F-Fluoride PET has the potential to become a useful tool for the noninvasive assessment of regional bone perfusion and metabolism in patients with metabolic bone disease (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). However, knowledge of the precision of this technique is vital for the accurate interpretation of changes in fluoride kinetic parameters observed in response to treatment or with disease progression and for the planning of future studies.…”

“…To date, the spine has been the site of choice in most studies using 18 F-fluoride PET. The reasons are that the change in bone metabolism is greater than that observed at other skeletal sites; the aorta lies within the field of view, allowing noninvasive estimation of the input function (1)(2)(3)(4)7,12,25); and the size and shape of the vertebral bodies make them amenable to accurate image analysis. This study has shown, for what is to our knowledge the first time, that the precision of 18 F-fluoride at the spine is equivalent to that observed using the commonly applied biochemical markers of global bone metabolism.…”

“…The functional imaging technique of 18 F-fluoride PET allows a direct quantitative assessment of bone metabolism at specific sites of the skeleton (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In the early 1990s, when 18 F-FDG PET was evolving as a major tool in the field of oncology, 18 F-fluoride PET was introduced as a technique for quantifying bone metabolism by Hawkins et al, who first described the 3-compartmental kinetic model that can be applied in clinical studies (7).…”

“…First, it is noninvasive, making it attractive in a clinical setting, and second, it can provide information about specific skeletal sites. 18 F-Fluoride PET has been used in several clinical studies investigating variations in regional bone metabolism with type and severity of metabolic bone disease, including osteoporosis, renal osteodystrophy, and Paget's disease (2,4,8,9,12). This technique can be used to quantify therapeutic response in those with osteoporosis (3) and those with Paget's disease treated with bisphosphonates (8).…”

18F-fluoride PET as a noninvasive imaging biomarker for determining treatment efficacy of bone active agents at the hip: A prospective, randomized, controlled clinical study

“…(23,27) The data from the PET dynamic scan were processed using Patlak graphical analysis to estimate regional bone plasma clearance of 18 F-fluoride to bone tissue (K i ) at different sites at the hip and pelvis. The Patlak plot, described in full elsewhere, (12,19,28) is a graphical analysis technique that assumes that 18 F -is taken up by two compartments, a central compartment that is in rapid equilibrium with plasma and a peripheral bone mineral compartment that tracer enters without ever leaving during the time of the measurements. The net amount of tracer in the bone ROI is given by:…”