18F-NaF PET/CT IMAGING IN FIBROUS DYSPLASIA OF BONE

Georgios Z. Papadakis, Georgios C. Manikis, Apostolos H. Karantanas, Pablo Florenzano, Ulas Bagci, Kostas Marias, Michael T. Collins, Alison M. Boyce*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Fibrous dysplasia (FD) is a mosaic skeletal disorder resulting in fractures, deformity, and functional impairment. Clinical evaluation has been limited by a lack of surrogate endpoints capable of quantitating disease activity. The purpose of this study was to investigate the utility of 18F-NaF PET/CT imaging in quantifying disease activity in patients with FD. Fifteen consecutively evaluated subjects underwent whole-body 18F-NaF PET/CT scans, and FD burden was assessed by quantifying FD-related 18F-NaF activity. 18F-NaF PET/CT parameters obtained included (i) SUVmax (standardized uptake value [SUV] of the FD lesion with the highest uptake); (ii) SUVmean (average SUV of all 18F-NaF–positive FD lesions); (iii) total volume of all 18F-NaF–positive FD lesions (TV); and (iv) total FD lesion activity determined as the product of TV multiplied by SUVmean (TA = TV × SUVmean) (TA). Skeletal outcomes, functional outcomes, and bone turnover markers were correlated with 18F-NaF PET/CT parameters. TV and TA of extracranial FD lesions correlated strongly with skeletal outcomes including fractures and surgeries (p values ≤ 0.003). Subjects with impaired ambulation and scoliosis had significantly higher TV and TA values (P < 0.05), obtained from extracranial and spinal lesions, respectively. Craniofacial surgeries correlated with TV and TA of skull FD lesions (P < 0.001). Bone turnover markers, including alkaline phosphatase, N-telopeptides, and osteocalcin, were strongly correlated with TV and TA (P < 0.05) extracted from FD lesions in the entire skeleton. No associations were identified with SUVmax or SUVmean. Bone pain and age did not correlate with 18F-NaF PET/CT parameters. FD burden evaluated by 18F-NaF-PET/CT facilitates accurate assessment of FD activity, and correlates quantitatively with clinically-relevant skeletal outcomes.

Original languageEnglish (US)
Pages (from-to)1619-1631
Number of pages13
JournalJournal of Bone and Mineral Research
Volume34
Issue number9
DOIs
StatePublished - Sep 1 2019
Externally publishedYes

Keywords

  • ANALYSIS/QUANTITATION OF BONE (OTHER)
  • BIOCHEMICAL MARKERS OF BONE TURNOVER
  • DISEASES AND DISORDERS OF/RELATED TO BONE (OTHER)

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

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