First experience with early dynamic 18F-NaF-PET/CT in patients with chronic osteomyelitis

Freesmeyer, Martin; Stecker, F. F.; Schierz, Jan-Henning; Hofmann, Gunther O.; Winkens, Thomas

doi:10.1007/s12149-014-0810-4

Cited by 24 publications

(34 citation statements)

References 17 publications

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“…In line with the non-quantitative studies mentioned in the introduction, i.e. [4, 5, 7, 9, 10], we found increased blood perfusion in the OM lesions (Table 3), as well as in the ST lesions (Table 4). However, as hypothesized, we found a quite clear distinction between the OM lesions and the ST lesions as the increase was significantly higher in the infected soft tissues than in the osteomyelitic lesions.…”

Section: Discussionsupporting

confidence: 91%

“…The study did not report quantitative perfusion, though, but found PET/CT valuable as a tool in the assessment. Two recent papers describe experiences with dynamic PET/CT, using [ 18 F]NaF [9] or [ 18 F]FDG [10] as tracer; both studies reported increased standardized uptake values (SUV) in the volume of interest (VOI) positioned at the site of chronic OM infection.…”

Section: Introductionmentioning

confidence: 99%

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Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

et al. 2017

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BackgroundOsteomyelitis is a serious disease which can be difficult to treat despite properly instituted antibiotic therapy. This appears to be related at least partly to degraded vascularisation in the osteomyelitic (OM) lesions. Studies of perfusion in OM bones are, however, few and not quantitative. Quantitative assessment of perfusion could aid in the selection of therapy. A non-invasive, quantitative way to study perfusion is dynamic [15O]water positron emission tomography (PET). We aim to demonstrate that the method can be used for measuring perfusion in OM lesions and hypothesize that perfusion will be less elevated in OM lesions than in soft tissue (ST) infection. The study comprised 11 juvenile pigs with haematogenous osteomyelitis induced by injection of Staphylococcus aureus into the right femoral artery 1 week before scanning (in one pig, 2 weeks). The pigs were dynamically PET scanned with [15O]water to quantify blood perfusion. OM lesions (N = 17) in long bones were studied, using the left limb as reference. ST lesions (N = 8) were studied similarly.ResultsPerfusion was quantitatively determined. Perfusion was elevated by a factor 1.5 in OM lesions and by a factor 6 in ST lesions.ConclusionsBlood perfusion was successfully determined in pathological subacute OM lesions; average perfusion was increased compared to that in a healthy bone, but as hypothesized, the increase was less than in ST lesions, indicating that the infected bone has less perfusion reserve than the infected soft tissue.Electronic supplementary materialThe online version of this article (doi:10.1186/s13550-016-0251-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

et al. 2017

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“…Specifically, the radionuclide angiographic and blood pool phase images of a traditional 99m Tc-MDP three-phase bone scintigraphic examination are not routinely possible with 18 F-NaF PET/CT because standard images can be acquired 90 minutes after injection. However, 18 F-NaF PET/CT has emerging potential to become a substitute for two-phase bone scintigraphy in the identification of bone inflammation (25). Depending on the type of PET scanner used, 18 F-NaF PET/CT could be performed similarly to a three-phase bone scintigraphic examination by obtaining a short dynamic acquisition within the first 10 minutes after the injection.…”

Section: Comparison Of 18 F-naf and 99m Tc-mdp As Bone Agentsmentioning

confidence: 99%

“…Depending on the type of PET scanner used, 18 F-NaF PET/CT could be performed similarly to a three-phase bone scintigraphic examination by obtaining a short dynamic acquisition within the first 10 minutes after the injection. This acquisition could conceivably represent the angiographic and blood pool phases of threephase bone scintigraphy (25,26). The utility of such an approach has not been thoroughly investigated, and prospective studies are needed before its incorporation into routine clinical practice.…”

Section: Comparison Of 18 F-naf and 99m Tc-mdp As Bone Agentsmentioning

confidence: 99%

Newer PET Application with an Old Tracer: Role of¹⁸F-NaF Skeletal PET/CT in Oncologic Practice

Bastawrous¹,

Bhargava²,

Behnia³

et al. 2014

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The skeleton is one of the most common sites for metastatic disease, particularly from breast and prostate cancer. Bone metastases are associated with considerable morbidity, and accurate imaging of the skeleton is important in determining the appropriate therapeutic plan. Sodium fluoride labeled with fluorine 18 (sodium fluoride F 18 [(18)F-NaF]) is a positron-emitting radiopharmaceutical first introduced several decades ago for skeletal imaging. (18)F-NaF was approved for clinical use as a positron emission tomographic (PET) agent by the U.S. Food and Drug Administration in 1972. The early use of this agent was limited, given the difficulties of imaging its high-energy photons on the available gamma cameras. For skeletal imaging, it was eventually replaced by technetium 99m ((99m)Tc)-labeled agents because of the technical limitations of (18)F-NaF. During the past several years, the widespread availability and implementation of hybrid PET and computed tomographic (CT) dual-modality systems (PET/CT) have encouraged a renewed interest in (18)F-NaF PET/CT for routine clinical use in bone imaging. Because current PET/CT systems offer high sensitivity and spatial resolution, the use of (18)F-NaF has been reevaluated for the detection of malignant and nonmalignant osseous disease. Growing evidence suggests that (18)F-NaF PET/CT provides increased sensitivity and specificity in the detection of bone metastases. Furthermore, the favorable pharmacokinetics of (18)F-NaF, combined with the superior imaging characteristics of PET/CT, supports the routine clinical use of (18)F-NaF PET/CT for oncologic imaging for skeletal metastases. In this article, a review of the indications, imaging appearances, and utility of (18)F-NaF PET/CT in the evaluation of skeletal disease is provided, with an emphasis on oncologic imaging.

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“…A recent study shows the NaF18 PET imaging modality is of higher resolution than PET. NaF18 PET images have higher sensitivity than bone scan for identifying osseous metastasis, but this technique is not available clinically [20].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Metastasis on TC-99m MDP Bone Scan Mimicking Metastatic Rib Lesions in Breast Cancer

Cao

Heath²,

Liang³

et al. 2014

J Nucl Med Radiat Ther

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Bone scan has been widely employed to detect osteoblastic bone metastasis because of the imaging technique's high sensitivity. However, care should be taken to distinguish false positive bone lesions which result from microcalcification of soft tissue malignancy with real osseous metastasis by correlating other modalities of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). We report, for the first time, a patient who was initially diagnosed with stage II left breast infiltrating ductal carcinoma and was under clinical management for 20 years. The patient subsequently presented with thoracic symptoms. Bone scan showed multiple focal uptakes within bilateral thoracic ribs. FDG PET/CT scans, however, showed numerous metabolically active bilateral pulmonary nodules with no osseous lesions in ribs. This case demonstrates abnormal findings on bone scans mimicking metastatic rib lesions from micro-calcified pulmonary metastatic nodules in a patient with breast cancer. Thus, care should be taken to correlate interpretation of high sensitivity but non-specificity bone imaging with other modalities such as FDG PET/CT. Keywords:Whole body bone scan; FDG PET/CT; Breast cancer; Pulmonary metastasis; Bony metastasis SummaryTc-99m MDP whole body bone scan is very sensitive and widely applied for clinical staging, monitoring therapeutic response, and evaluating malignant tumor recurrence in patients with malignant cancers, specifically breast cancer in female patients, prostate cancer in male patients, and other cancers including pulmonary cancers. However, attention should be paid by clinicians when they dictate bone imaging given that the various false positive findings may diminish specificity of the study. We presented a case for the first time that demonstrates abnormal findings on bone scans mimicking metastatic rib lesions from micro-calcified pulmonary metastatic nodules in the patient with breast cancer.

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First experience with early dynamic 18F-NaF-PET/CT in patients with chronic osteomyelitis

Cited by 24 publications

References 17 publications

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

Newer PET Application with an Old Tracer: Role of¹⁸F-NaF Skeletal PET/CT in Oncologic Practice

Pulmonary Metastasis on TC-99m MDP Bone Scan Mimicking Metastatic Rib Lesions in Breast Cancer

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First experience with early dynamic 18F-NaF-PET/CT in patients with chronic osteomyelitis

Cited by 24 publications

References 17 publications

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

Newer PET Application with an Old Tracer: Role of18F-NaF Skeletal PET/CT in Oncologic Practice

Pulmonary Metastasis on TC-99m MDP Bone Scan Mimicking Metastatic Rib Lesions in Breast Cancer

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Newer PET Application with an Old Tracer: Role of¹⁸F-NaF Skeletal PET/CT in Oncologic Practice