Lundblad Henrik, Maguire Gerald Q, Olivecrona Henrik, Jonsson Cathrine, Jacobsson Hans, Noz Marilyn E, Zeleznik Michael P, Weidenhielm Lars, Sundin Anders
Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institute, A2:07, 171 76 Stockholm, Sweden.
School of Information and Communication Technology, KTH Royal Institute of Technology, Isafjordsgatan 26, 418 164-40 Stockholm, Sweden.
ScientificWorldJournal. 2014 Mar 19;2014:249326. doi: 10.1155/2014/249326. eCollection 2014.
Monitoring and quantifying bone remodeling are of interest, for example, in correction osteotomies, delayed fracture healing pseudarthrosis, bone lengthening, and other instances. Seven patients who had operations to attach an Ilizarov-derived Taylor Spatial Frame to the tibia gave informed consent. Each patient was examined by Na(18)F PET/CT twice, at approximately six weeks and three months after the operation. A validated software tool was used for the following processing steps. The first and second CT volumes were aligned in 3D and the respective PET volumes were aligned accordingly. In the first PET volume spherical volumes of interest (VOIs) were delineated for the crural fracture and normal bone and transferred to the second PET volume for SUVmax evaluation. This method potentially provides clinical insight into questions such as, when has the bone remodeling progressed well enough to safely remove the TSF? and when is intervention required, in a timelier manner than current methods? For example, in two patients who completed treatment, the SUVmax between the first and second PET/CT examination decreased by 42% and 13%, respectively. Further studies in a larger patient population are needed to verify these preliminary results by correlating regional Na(18)F PET measurements to clinical and radiological findings.
例如，在截骨矫正术、骨折愈合延迟假关节、骨延长及其他情况中，监测和量化骨重塑很有意义。7名接受手术将源自伊里扎洛夫技术的泰勒空间框架固定于胫骨的患者已签署知情同意书。每位患者在术后约6周和3个月时接受两次Na(18)F PET/CT检查。使用经过验证的软件工具进行以下处理步骤。将第一次和第二次CT容积进行三维对齐，并相应对齐各自的PET容积。在第一次PET容积中，为小腿骨折和正常骨划定感兴趣的球形容积（VOIs），并将其转移至第二次PET容积以评估SUVmax。该方法可能为以下问题提供临床见解，如骨重塑进展到何种程度才足以安全移除TSF？以及何时需要干预，比现有方法更及时？例如，在两名完成治疗的患者中，第一次和第二次PET/CT检查之间的SUVmax分别下降了42%和13%。需要在更大的患者群体中进行进一步研究，通过将局部Na(18)F PET测量结果与临床和放射学结果相关联来验证这些初步结果。
