Pons F, Alvarez L, Peris P, Guañabens N, Vidal-Sicart S, Monegal A, Pavía J, Ballesta A M, Muños-Gómez J, Herranz R
Department of Nuclear Medicine, University of Barcelona, Spain.
Nucl Med Commun. 1999 Jun;20(6):525-8. doi: 10.1097/00006231-199906000-00006.
Interest in the assessment of activity of Paget's disease has increased since the advent of effective therapies. The aim of this study was to develop a quantitative method for the scintigraphic assessment of Paget's disease activity in bone. Twenty patients with Paget's disease were studied prospectively. A scintigraphic visual activity index, together with a quantitative activity index that reflects both the extent and activity of the disease, was obtained for each patient. The quantitative activity index is calculated as the sum of the activity (geometric mean measured from the anterior and posterior views) for all affected bones divided by a reference obtained in non-affected bone. To evaluate the validity of the scintigraphic methods, several biochemical markers of bone turnover were assessed: serum total alkaline phosphatase and serum propeptide aminoterminal of type I procollagen (PINP) as markers of bone formation; urinary hydroxyproline and urinary N-terminal cross-linked telopeptide of type I collagen (NTx) as markers of bone resorption. The visual and quantitative scintigraphic indices were highly correlated (r = 0.78, P < 0.0001). The highest correlations between the biochemical markers and the quantitative activity index were found for PINP (r = 0.69, P < 0.001), which was the most sensitive marker of bone formation, and for urinary NTx (r = 0.63, P < 0.005), which was the most sensitive marker of bone resorption. In conclusion, quantitative evaluation of bone scintigraphy allows easy and objective assessment of Paget's disease activity and it may be useful in evaluating the effectiveness of therapies.
自有效治疗方法出现以来，对佩吉特病活动评估的关注度有所增加。本研究的目的是开发一种用于骨闪烁显像评估佩吉特病活动的定量方法。对20例佩吉特病患者进行了前瞻性研究。为每位患者获得了闪烁显像视觉活动指数以及反映疾病范围和活动的定量活动指数。定量活动指数的计算方法是，将所有受累骨骼的活动（从前位和后位视图测量的几何平均值）之和除以在未受累骨骼中获得的参考值。为了评估闪烁显像方法的有效性，评估了几种骨转换的生化标志物：血清总碱性磷酸酶和血清I型前胶原氨基末端前肽（PINP）作为骨形成标志物；尿羟脯氨酸和尿I型胶原N末端交联端肽（NTx）作为骨吸收标志物。视觉和定量闪烁显像指数高度相关（r = 0.78，P < 0.0001）。在生化标志物与定量活动指数之间发现，骨形成最敏感的标志物PINP（r = 0.69，P < 0.001）以及骨吸收最敏感的标志物尿NTx（r = 0.63，P < 0.005）之间的相关性最高。总之，骨闪烁显像的定量评估能够轻松、客观地评估佩吉特病的活动，并且可能有助于评估治疗效果。
