Department of Nuclear Medicine, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.
Department of Anaesthesiology, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.
Mol Imaging Biol. 2023 Oct;25(5):815-823. doi: 10.1007/s11307-023-01834-5. Epub 2023 Jul 11.
Chronic kidney disease (CKD) is prevalent in the aging population and increases the risk of fracture 2-4 times. We compared optimized quantitative [F]fluoride PET/CT methods to the reference standard with arterial input function (AIF) to identify a clinically accessible method for evaluation of bone turnover in patients with CKD.
Ten patients on chronic hemodialysis treatment and ten control patients were recruited. A dynamic 60-min [F]fluoride PET scan was obtained from the 5th lumbar vertebra to the proximal femur simultaneously with arterial blood sampling to achieve an AIF. Individual AIFs were time-shifted to compute a population curve (PDIF). Bone and vascular volumes-of-interest (VOIs) were drawn, and an image-derived-input-function (IDIF) was extracted. PDIF and IDIF were scaled to plasma. Bone turnover (K) was calculated with the AIF, PDIF, and IDIF and bone VOIs using a Gjedde-Patlak plot. Input methods were compared using correlations and precision errors.
The calculated K from the five non-invasive methods all correlated to the K from the AIF method with the PDIF scaled to a single late plasma sample showing the highest correlations (r > 0.94), and the lowest precision error of 3-5%. Furthermore, the femoral bone VOI's correlated positively to p-PTH and showed significant differences between patients and controls.
Dynamic 30 min [F]fluoride PET/CT with a population based input curve scaled to a single venous plasma sample is a feasible and precise non-invasive diagnostic method for the assessment of bone turnover in patients with CKD. The method may potentially allow for earlier and more precise diagnosis and may be useful for assessment of treatment effects, which is crucial for development of future treatment strategies.
慢性肾脏病（CKD）在老年人群中较为普遍，使骨折风险增加 2-4 倍。我们比较了优化的定量[F]氟化物 PET/CT 方法与参考标准（动脉输入函数[AIF]），以确定一种可用于评估 CKD 患者骨转换的临床可及方法。
招募了 10 名接受慢性血液透析治疗的患者和 10 名对照患者。同时从第 5 腰椎到股骨近端进行 60 分钟的动态[F]氟化物 PET 扫描，并进行动脉采血以获得 AIF。个体 AIF 被时移以计算群体曲线（PDIF）。绘制骨和血管感兴趣区（VOI），并提取图像衍生输入函数（IDIF）。PDIF 和 IDIF 被缩放至血浆。使用 Gjedde-Patlak 图，使用 AIF、PDIF 和 IDIF 以及骨 VOI 计算骨转换（K）。使用相关性和精度误差比较输入方法。
五种非侵入性方法计算的 K 均与 AIF 方法的 K 相关，其中 PDIF 缩放到单个晚期血浆样本显示出最高的相关性（r>0.94），精度误差最低为 3-5%。此外，股骨骨 VOI 与 p-PTH 呈正相关，且患者与对照组之间存在显著差异。
用基于群体的输入曲线缩放至单个静脉血浆样本的 30 分钟动态[F]氟化物 PET/CT 是一种可行且精确的非侵入性诊断方法，可用于评估 CKD 患者的骨转换。该方法可能有助于更早、更精确的诊断，并可能对评估治疗效果有用，这对未来治疗策略的发展至关重要。
