Lee Dong Yun, Oh Jungsu S, Kim Ji Wan, Lee Seung Hun, Kim Beom-Jun, Koh Jung-Min, Kim Jae Seung, Ryu Jin-Sook
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
EJNMMI Res. 2024 Aug 25;14(1):75. doi: 10.1186/s13550-024-01137-y.
Serum bone turnover markers offer limited insight into metabolic activity at the individual vertebra level in osteoporosis. This study introduces a novel image-derived bone turnover marker for individual vertebrae to address this limitation, utilizing volumetric density-adjusted quantitative bone single-photon emission computed tomography/computed tomography (SPECT/CT) with [Tc]Tc-DPD. This retrospective study included 177 lumbar vertebrae from 55 postmenopausal South Korean women. The mean standardized uptake value (SUV, g/cm) and volumetric bone mineral density (vBMD, mg/cm) were determined within a 2-cm³ volume of interest in the trabecular portion of each vertebra using quantitative SPECT and CT. The density-adjusted mean standardized uptake value (dSUV) was calculated by dividing the SUV by the vBMD and multiplying by 1,000.
SUV correlated positively with vBMD (r = 0.60, p < 0.001). Conversely, dSUV correlated negatively with vBMD (ρ = -0.66, p < 0.001), highlighting the inverse relationship between bone mass and turnover after density adjustment of SUV. Patients with major osteoporotic fractures had lower vBMD (62.5 ± 29.4 vs. 92.3 ± 27.4 mg/cm³, p = 0.001) but higher dSUV (100.8 ± 60.7 vs. 62.6 ± 17.5, p = 0.001) compared to those without fractures, reinforcing the association between fracture prevalence, low bone mass, and high bone turnover.
Volumetric density-adjusted quantitative bone SPECT/CT offers a novel image-derived bone turnover marker for assessing bone turnover in osteoporosis. This method provides a precise assessment of fragility at the individual vertebra level, which may enhance personalized osteoporosis management.
血清骨转换标志物对骨质疏松症患者个体椎体水平的代谢活性了解有限。本研究引入了一种用于个体椎体的新型图像衍生骨转换标志物，以解决这一局限性，该标志物利用体积密度调整后的定量骨单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）结合[锝]Tc-DPD。这项回顾性研究纳入了55名韩国绝经后女性的177个腰椎椎体。使用定量SPECT和CT在每个椎体小梁部分2cm³的感兴趣区域内测定平均标准化摄取值（SUV，g/cm）和体积骨密度（vBMD，mg/cm）。密度调整后的平均标准化摄取值（dSUV）通过将SUV除以vBMD并乘以1000来计算。
SUV与vBMD呈正相关（r = 0.60，p < 0.001）。相反，dSUV与vBMD呈负相关（ρ = -0.66，p < 0.001），突出了SUV密度调整后骨量与骨转换之间的反比关系。与未发生骨折的患者相比，发生严重骨质疏松性骨折的患者vBMD较低（62.5±29.4 vs. 92.3±27.4mg/cm³，p = 0.001），但dSUV较高（100.8±60.7 vs. 62.6±17.5，p = 0.001），这进一步证实了骨折发生率、低骨量和高骨转换之间的关联。
体积密度调整后的定量骨SPECT/CT提供了一种用于评估骨质疏松症骨转换的新型图像衍生骨转换标志物。该方法可在个体椎体水平精确评估骨折风险，这可能有助于加强骨质疏松症的个性化管理。
