Lim Ruth, Fahey Frederic H, Drubach Laura A, Connolly Leonard P, Treves S Ted
Division of Nuclear Medicine, Department of Radiology, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
J Pediatr Orthop. 2007 Apr-May;27(3):277-82. doi: 10.1097/BPO.0b013e31803409ba.
Skeletal positron emission tomography (PET) with fluorine-18 (18F) sodium fluoride (18F NaF) is an alternative to technetium-99m (99mTc)methylene diphosphonate (MDP) scintigraphy. Experience with pediatric PET is sparse, primarily in oncology. This study assesses the role of 18F NaF in evaluating young patients with back pain.
Ninety-four 18F NaF PET scans were performed in 94 patients (27 males, 67 females; mean age, 15 years; range, 4-26 years) with back pain. Three-dimensional PET acquisition was performed 30 minutes after administration of 18F NaF (2.1 MBq/kg; maximum, 148 MBq). Radiation doses are presented for 18F NaF and 99mTc MDP.
18F NaF PET revealed a possible cause of back pain in 55% (52/94). Fifteen patients had 2 or more potential sources of back pain. Diagnoses by PET were pars interarticularis/pedicle stress (34%), spinous process injury (16%), vertebral body ring apophyseal injury (14%), stress at a transitional vertebra-sacral articulation (7%), and sacroiliac joint inflammation/stress (3%). Comparing 18F NaF PET with 99mTc MDP scintigraphy, time between injection and scanning was shorter (0.5 hours vs 3 hours), radiation dosimetry was similar (3.5 mGy vs 2.8 mGy effective dose for a 55-kg patient for 18F NaF and 99mTc MDP, respectively), and cost of radiopharmaceutical was higher.
18F NaF bone PET can detect a variety of skeletal abnormalities in young patients with back pain. Relative to 99mTc MDP, images are of higher resolution. Total time from tracer administration to completion is shorter, and radiation dosimetry is similar. Higher cost for 18F NaF may be offset by enhanced patient throughput.
使用氟 - 18（¹⁸F）氟化钠（¹⁸F NaF）的骨骼正电子发射断层扫描（PET）是锝 - 99m（⁹⁹mTc）亚甲基二膦酸盐（MDP）闪烁扫描的替代方法。儿科PET的经验较少，主要集中在肿瘤学领域。本研究评估¹⁸F NaF在评估背痛年轻患者中的作用。
对94例背痛患者（27例男性，67例女性；平均年龄15岁；范围4 - 26岁）进行了94次¹⁸F NaF PET扫描。在给予¹⁸F NaF（2.1 MBq/kg；最大148 MBq）后30分钟进行三维PET采集。给出了¹⁸F NaF和⁹⁹mTc MDP的辐射剂量。
¹⁸F NaF PET显示55%（52/94）的背痛患者有背痛的可能原因。15例患者有2个或更多潜在的背痛来源。PET诊断为关节突/椎弓根应力（34%）、棘突损伤（16%）、椎体环骨骺损伤（14%）、过渡椎 - 骶关节应力（7%）和骶髂关节炎症/应力（3%）。将¹⁸F NaF PET与⁹⁹mTc MDP闪烁扫描进行比较，注射与扫描之间的时间更短（0.5小时对3小时），辐射剂量测定相似（对于一名55千克患者，¹⁸F NaF和⁹⁹mTc MDP的有效剂量分别为3.5 mGy和2.8 mGy），放射性药物成本更高。
¹⁸F NaF骨PET可以检测背痛年轻患者的各种骨骼异常。相对于⁹⁹mTc MDP，图像分辨率更高。从注射示踪剂到完成检查的总时间更短，辐射剂量测定相似。¹⁸F NaF较高的成本可能因患者通量增加而得到抵消。
