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18 F‐N a F PET/CT IMAGING IN FIBROUS DYSPLASIA OF BONE
Author(s) -
Papadakis Georgios Z,
Manikis Georgios C,
Karantanas Apostolos H,
Florenzano Pablo,
Bagci Ulas,
Marias Kostas,
Collins Michael T,
Boyce Alison M
Publication year - 2019
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.3738
Subject(s) - fibrous dysplasia , medicine , nuclear medicine , craniofacial , lesion , standardized uptake value , bone remodeling , positron emission tomography , pathology , psychiatry
Fibrous dysplasia (FD) is a mosaic skeletal disorder resulting in fractures, deformity, and functional impairment. Clinical evaluation has been limited by a lack of surrogate endpoints capable of quantitating disease activity. The purpose of this study was to investigate the utility of 18 F‐NaF PET/CT imaging in quantifying disease activity in patients with FD. Fifteen consecutively evaluated subjects underwent whole‐body 18 F‐NaF PET/CT scans, and FD burden was assessed by quantifying FD‐related 18 F‐NaF activity. 18 F‐NaF PET/CT parameters obtained included (i) SUV max (standardized uptake value [SUV] of the FD lesion with the highest uptake); (ii) SUV mean (average SUV of all 18 F‐NaF–positive FD lesions); (iii) total volume of all 18 F‐NaF–positive FD lesions (TV); and (iv) total FD lesion activity determined as the product of TV multiplied by SUV mean (TA = TV × SUV mean ) (TA). Skeletal outcomes, functional outcomes, and bone turnover markers were correlated with 18 F‐NaF PET/CT parameters. TV and TA of extracranial FD lesions correlated strongly with skeletal outcomes including fractures and surgeries ( p values ≤ 0.003). Subjects with impaired ambulation and scoliosis had significantly higher TV and TA values ( P < 0.05), obtained from extracranial and spinal lesions, respectively. Craniofacial surgeries correlated with TV and TA of skull FD lesions ( P < 0.001). Bone turnover markers, including alkaline phosphatase, N‐telopeptides, and osteocalcin, were strongly correlated with TV and TA ( P < 0.05) extracted from FD lesions in the entire skeleton. No associations were identified with SUV max or SUV mean . Bone pain and age did not correlate with 18 F‐NaF PET/CT parameters. FD burden evaluated by 18 F‐NaF‐PET/CT facilitates accurate assessment of FD activity, and correlates quantitatively with clinically‐relevant skeletal outcomes. © 2019 American Society for Bone and Mineral Research.