Freesmeyer Martin, Stecker Franz F, Schierz Jan-Henning, Hofmann Gunther O, Winkens Thomas
Clinic of Nuclear Medicine, Jena University Hospital, Bachstrasse 18, 07743, Jena, Germany,
Ann Nucl Med. 2014 May;28(4):314-21. doi: 10.1007/s12149-014-0810-4. Epub 2014 Jan 29.
This study investigates whether early dynamic positron emission tomography/computed tomography (edPET/CT) using (18)F-sodium fluoride-((18)F-NaF) is feasible in depicting early phases of radiotracer distribution in patients with chronic osteomyelitis (COM).
A total of 12 ed(18)F-NaF-PET/CT examinations were performed on 11 consecutive patients (2 female, 9 male; age 53 ± 12 years) in list mode over 5 min starting with radiopharmaceutical injection before standard late (18)F-NaF-PET/CT. Eight consecutive time intervals (frames) were reconstructed for each patient: four 15 s, then four 60 s. Several volumes of interest (VOI) were selected, representing the affected area as well as different reference areas within the bone and soft tissue. Maximum and mean ed standardized uptake values (edSUVmax, edSUVmean, respectively) were calculated in each VOI during each frame to measure early fluoride influx and accumulation. Results were compared between affected and non-affected (contralateral) bones.
Starting in the 31-45 s frame, the affected bone area showed significantly higher edSUVmax and edSUVmean compared to the healthy contralateral region. The affected bone areas also significantly differed from non-affected contralateral regions in conventional late (18)F-NaF-PET/CT.
This pilot study suggests that, in patients with COM, ed(18)F-NaF -PET offers additional information about early radiotracer distribution to standard (18)F-NaF -PET/CT, similar to a three-phase bone scan. The results should be validated in larger trials which directly compare ed(18)F-NaF-PET to a three-phase bone scan.
本研究旨在探讨使用（18）F - 氟化钠（（18）F - NaF）的早期动态正电子发射断层扫描/计算机断层扫描（edPET/CT）在描绘慢性骨髓炎（COM）患者放射性示踪剂分布早期阶段方面是否可行。
对11例连续患者（2例女性，9例男性；年龄53±12岁）进行了总共12次ed（18）F - NaF - PET/CT检查，以列表模式在5分钟内进行，从注射放射性药物开始，在标准延迟（18）F - NaF - PET/CT之前。为每位患者重建了连续八个时间间隔（帧）：四个15秒，然后四个60秒。选择了几个感兴趣区域（VOI），代表受影响区域以及骨骼和软组织内的不同参考区域。在每个帧期间，在每个VOI中计算最大和平均ed标准化摄取值（分别为edSUVmax、edSUVmean），以测量早期氟流入和积累。比较了受影响和未受影响（对侧）骨骼之间的结果。
从31 - 45秒帧开始，与健康对侧区域相比，受影响的骨区域显示出显著更高的edSUVmax和edSUVmean。在传统延迟（18）F - NaF - PET/CT中，受影响的骨区域与未受影响的对侧区域也有显著差异。
这项初步研究表明，在COM患者中，ed（18）F - NaF - PET为标准（18）F - NaF - PET/CT提供了有关早期放射性示踪剂分布的额外信息，类似于三相骨扫描。结果应在将ed（18）F - NaF - PET与三相骨扫描直接比较的更大试验中进行验证。
