Peters Marloes J M, Wierts Roel, Jutten Elisabeth M C, Halders Servé G E A, Willems Paul C P H, Brans Boudewijn
Department of Orthopedic Surgery, Maastricht University Medical Center, Postbox 5800, 6202 AZ, Maastricht, The Netherlands.
Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Ann Nucl Med. 2015 Nov;29(9):799-809. doi: 10.1007/s12149-015-1008-0. Epub 2015 Aug 5.
OBJECTIVE: A complication after spinal fusion surgery is pseudarthrosis, but its radiological diagnosis is of limited value. (18)F-fluoride PET with its ability to assess bone metabolism activity could be of value. The goal of this study was to assess the clinical feasibility of calculating the static standardized uptake value (SUV) from a short dynamic scan without the use of blood sampling, thereby obtaining all dynamic and static parameters in a scan of only 30 min. This approach was tested on a retrospective patient population with persisting pain after spinal fusion surgery. METHODS: In 16 patients, SUVs (SUV max, SUV mean) and kinetic parameters (K 1, k 2, k 3, v b, K i,NLR, K 1/k 2, k 3/(k 2 + k 3), K i,patlak) were derived from static and dynamic PET/CT scans of operated and control regions of the spine, after intravenous administration of 156-214 MBq (18)F-fluoride. Parameter differences between control and operated regions, as well as between pseudarthrosis and fused segments were evaluated. SUVmean at 30 and 60 min was calculated from kinetic parameters obtained from the dynamic data set (SUV mean,2TCM). Agreement between measured and calculated SUVs was evaluated through Bland-Altman plots. RESULTS: Overall, statistically significant differences between control and operated regions were observed for SUV max, SUV mean, K i,NLR, K i,patlak, K 1/k 2 and k 3/(k 2 + k 3). Diagnostic CT showed pseudarthrosis in 6/16 patients, while in 10/16 patients, segments were fused. Of all parameters, only those regarding the incorporation of bone [K i,NLR, K i,patlak, k 3/(k 2 + k 3)] differed statistically significant in the intervertebral disc space between the pseudarthrosis and fused patients group. The mean values of the patient-specific blood clearance rate [Formula: see text] differed statistically significant between the pseudarthrosis and the fusion group, with a p value of 0.011. This may correspond with the lack of statistical significance of the SUV values between pseudarthrosis and fused patients. Bland-Altman plots show that calculated SUV mean,2TCM values corresponded well with the measured SUV mean values. CONCLUSION: This study shows the feasibility of a 30-min dynamic (18)F-fluoride PET/CT scanning and this may provide dynamic parameters clinically relevant to the diagnosis of pseudarthrosis.
目的：脊柱融合手术后的一种并发症是假关节形成，但其影像学诊断价值有限。具有评估骨代谢活性能力的（18）F - 氟化物PET可能具有价值。本研究的目的是评估在不进行血样采集的情况下，通过短动态扫描计算静态标准化摄取值（SUV）的临床可行性，从而在仅30分钟的扫描中获得所有动态和静态参数。该方法在脊柱融合手术后持续疼痛的回顾性患者群体中进行了测试。 方法：对16例患者静脉注射156 - 214 MBq（18）F - 氟化物后，从脊柱手术区域和对照区域的静态和动态PET/CT扫描中得出SUV（SUV最大值、SUV平均值）和动力学参数（K1、k2、k3、vb、Ki、NLR、K1/k2、k3/（k2 + k3）、Ki、patlak）。评估对照区域与手术区域之间以及假关节与融合节段之间的参数差异。根据从动态数据集中获得的动力学参数计算30分钟和60分钟时的SUV平均值（SUV平均值，2TCM）。通过Bland - Altman图评估测量的SUV与计算的SUV之间的一致性。 结果：总体而言，在SUV最大值、SUV平均值、Ki、NLR、Ki、patlak、K1/k2和k3/（k2 + k3）方面，观察到对照区域与手术区域之间存在统计学上的显著差异。诊断性CT显示16例患者中有6例存在假关节形成，而16例患者中有10例节段融合。在所有参数中，只有那些与骨摄取相关的参数[Ki、NLR、Ki、patlak、k3/（k2 + k3）]在假关节患者组和融合患者组之间的椎间盘间隙中存在统计学上的显著差异。假关节组和融合组之间患者特异性血清除率[公式：见原文]的平均值存在统计学上的显著差异，p值为0.011。这可能与假关节患者和融合患者之间SUV值缺乏统计学意义相对应。Bland - Altman图显示计算的SUV平均值，2TCM值与测量的SUV平均值吻合良好。 结论：本研究表明30分钟动态（18）F - 氟化物PET/CT扫描具有可行性，这可能为假关节诊断提供临床相关动态参数。
Eur J Nucl Med Mol Imaging. 2015-11
J Nucl Med. 2014-5-27
Tomography. 2021-10-25
J Nucl Med. 2014-5-27
Eur J Nucl Med Mol Imaging. 2012-8-16
Eur J Nucl Med Mol Imaging. 2011-11-8
Zotero 插件
