Dual‐phase hybrid 18F‐Fluoride Positron emission tomography/MRI in ankylosing spondylitis: Investigating the link between MRI bone changes, regional hyperaemia and increased osteoblastic activity

Medientyp: E-Artikel
Titel: Dual‐phase hybrid 18F‐Fluoride Positron emission tomography/MRI in ankylosing spondylitis: Investigating the link between MRI bone changes, regional hyperaemia and increased osteoblastic activity
Beteiligte: Sawicki, Lino M; Lütje, Susanne; Baraliakos, Xenofon; Braun, Jürgen; Kirchner, Julian; Boos, Johannes; Heusch, Philipp; Ruhlmann, Verena; Herrmann, Ken; Umutlu, Lale; Quick, Harald H; Antoch, Gerald; Buchbender, Christian
Erschienen: Wiley, 2018
Erschienen in: Journal of Medical Imaging and Radiation Oncology
Sprache: Englisch
DOI: 10.1111/1754-9485.12687
ISSN: 1754-9477; 1754-9485
Schlagwörter: Radiology, Nuclear Medicine and imaging ; Oncology
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Beschreibung: <jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Focal <jats:sup>18</jats:sup>F‐Fluoride uptake on blood‐pool phase <jats:styled-content style="fixed-case">PET</jats:styled-content> represents regional hyperaemia, while it indicates osteoblastic activity on mineralization phase <jats:styled-content style="fixed-case">PET</jats:styled-content>. This study investigates the link between regional hyperaemia and osteoblastic activity in inflammatory and chronic lesions of ankylosing spondylitis (<jats:styled-content style="fixed-case">AS</jats:styled-content>) of the sacroiliac joints (<jats:styled-content style="fixed-case">SIJ</jats:styled-content>) using dual‐phase <jats:sup>18</jats:sup>F‐Fluoride <jats:styled-content style="fixed-case">PET</jats:styled-content>/<jats:styled-content style="fixed-case">MRI</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Thirteen patients (six men, seven women, age: 37 ± 10 years) with active <jats:styled-content style="fixed-case">AS</jats:styled-content> prospectively underwent dual‐phase <jats:sup>18</jats:sup>F‐Fluoride <jats:styled-content style="fixed-case">PET</jats:styled-content>/<jats:styled-content style="fixed-case">MRI</jats:styled-content>. Blood‐pool phase <jats:styled-content style="fixed-case">PET</jats:styled-content> was acquired 6 min and mineralization phase <jats:styled-content style="fixed-case">PET</jats:styled-content> 40 min after injection of 158 ± 8 <jats:styled-content style="fixed-case">MB</jats:styled-content>q <jats:sup>18</jats:sup>F‐Fluoride. <jats:styled-content style="fixed-case">SIJ</jats:styled-content> quadrants (<jats:styled-content style="fixed-case">SQ</jats:styled-content>) were assessed regarding inflammatory lesions represented by bone marrow oedema (<jats:styled-content style="fixed-case">BME</jats:styled-content>), chronic <jats:styled-content style="fixed-case">AS</jats:styled-content> lesions such as erosion, fat deposition (<jats:styled-content style="fixed-case">FD</jats:styled-content>), sclerosis and ankylosis on <jats:styled-content style="fixed-case">MRI</jats:styled-content>, and regarding focal <jats:sup>18</jats:sup>F‐Fluoride uptake on both <jats:styled-content style="fixed-case">PET</jats:styled-content> datasets. Image quality (<jats:styled-content style="fixed-case">IQ</jats:styled-content>) of both <jats:styled-content style="fixed-case">PET</jats:styled-content> datasets and <jats:styled-content style="fixed-case">MRI</jats:styled-content> was evaluated using a 4‐point Likert scale.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 104 <jats:styled-content style="fixed-case">SQ</jats:styled-content>, there were 63.4% <jats:styled-content style="fixed-case">SQ</jats:styled-content> with <jats:styled-content style="fixed-case">FD</jats:styled-content>, 42.3% <jats:styled-content style="fixed-case">SQ</jats:styled-content> with <jats:styled-content style="fixed-case">BME</jats:styled-content>, 26.9% <jats:styled-content style="fixed-case">SQ</jats:styled-content> with erosions, 26% <jats:styled-content style="fixed-case">SQ</jats:styled-content> with sclerosis and 10.6% <jats:styled-content style="fixed-case">SQ</jats:styled-content> with ankylosis. <jats:styled-content style="fixed-case">BME</jats:styled-content> alone was associated with focal <jats:sup>18</jats:sup>F‐Fluoride uptake in 63.6% <jats:styled-content style="fixed-case">SQ</jats:styled-content> on blood‐pool phase and 90.9% <jats:styled-content style="fixed-case">SQ</jats:styled-content> on mineralization phase <jats:sup>18</jats:sup>F‐Fluoride <jats:styled-content style="fixed-case">PET</jats:styled-content>/<jats:styled-content style="fixed-case">MRI</jats:styled-content>. Instead, <jats:styled-content style="fixed-case">FD</jats:styled-content>, erosion, sclerosis, ankylosis were not associated with focal <jats:sup>18</jats:sup>F‐Fluoride uptake on either blood‐pool or mineralization phase <jats:sup>18</jats:sup>F‐Fluoride <jats:styled-content style="fixed-case">PET</jats:styled-content>/<jats:styled-content style="fixed-case">MRI</jats:styled-content>. <jats:styled-content style="fixed-case">SQ</jats:styled-content> showing <jats:styled-content style="fixed-case">BME</jats:styled-content> alone or a combination of <jats:styled-content style="fixed-case">BME</jats:styled-content> and chronic <jats:styled-content style="fixed-case">AS</jats:styled-content> lesions had a significantly higher percentage of focal <jats:sup>18</jats:sup>F‐Fluoride uptake on blood‐pool phase and mineralization phase <jats:styled-content style="fixed-case">PET</jats:styled-content>/<jats:styled-content style="fixed-case">MRI</jats:styled-content> than <jats:styled-content style="fixed-case">SQ</jats:styled-content> showing <jats:styled-content style="fixed-case">AS</jats:styled-content> lesions without <jats:styled-content style="fixed-case">BME</jats:styled-content> (<jats:italic>P</jats:italic> < 0.001). Both <jats:sup>18</jats:sup>F‐Fluoride <jats:styled-content style="fixed-case">PET</jats:styled-content> datasets provided high <jats:styled-content style="fixed-case">IQ</jats:styled-content>, albeit <jats:styled-content style="fixed-case">IQ</jats:styled-content> of mineralization phase <jats:styled-content style="fixed-case">PET</jats:styled-content> was superior to blood‐pool phase <jats:styled-content style="fixed-case">PET</jats:styled-content> (<jats:italic>P</jats:italic> < 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Dual‐phase <jats:sup>18</jats:sup>F‐Fluoride <jats:styled-content style="fixed-case">PET</jats:styled-content>/<jats:styled-content style="fixed-case">MRI</jats:styled-content> of the <jats:styled-content style="fixed-case">SIJ</jats:styled-content> showed that inflammatory rather than chronic <jats:styled-content style="fixed-case">AS</jats:styled-content> lesions are associated with regional hyperaemia and osteoblastic activity.</jats:p></jats:sec>

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