Utility of 18F sodium fluoride PET/CT imaging in the evaluation of postoperative pain following surgical spine fusion

Pouldar, David; Bakshian, S.; Matthews, Robert; Rao, Vvs Prabhakar; Manzano, Miguel; Dardashti, Siamak

doi:10.1007/s12306-017-0465-0

Cited by 9 publications

(10 citation statements)

References 19 publications

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“…A relationship with painful pseudarthrosis was suggested by Peters et al in a retrospective series of 36 patients, because after surgery 18F-NaF activity was reported to be significantly higher in patients with worse functional scores [ 41 ]. Abnormal foci of uptake appear to be related to the patient’s source of pain and could be located at various sites involved in arthrodesis (cages, screws, rods, or bone grafts) helping surgeons to choose the best management and strategy if a surgical revision is considered mandatory [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this series, implant stability and fusion were finally confirmed by radiological exams (X-rays of CT), helping us to adequately validate our results. As described by previous studies, the presence of pseudarthrosis, subsidence, or implants loosening could result in abnormal uptake, increasing over time and helping to discriminate between asymptomatic and symptomatic cases requiring revision [ 41 , 42 , 43 ]. According with our preliminary results [ 36 ], the use of custom-made TTCs is confirmed to represent a promising approach in order to achieve good stability promoting active osteo-integration and fusion, while minimizing subsidence rates.…”

Section: Discussionmentioning

confidence: 99%

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The Efficacy of Trabecular Titanium Cages to Induce Reparative Bone Activity after Lumbar Arthrodesis Studied through the 18f-Naf PET/CT Scan: Observational Clinical In-Vivo Study

et al. 2022

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Background: Titanium trabecular cages (TTCs) are emerging implants designed to achieve immediate and long-term spinal fixation with early osseointegration. However, a clear radiological and clinical demonstration of their efficacy has not yet been obtained. The purpose of this study was to evaluate the reactive bone activity of adjacent plates after insertion of custom-made titanium trabecular cages for the lumbar interbody with positron emission tomography (PET)/computed tomography (CT) 18F sodium fluoride (18F-NaF). Methods: This was an observational clinical study that included patients who underwent surgery for degenerative disease with lumbar interbody fusion performed with custom-made TTCs. Data related to the metabolic-reparative reaction following the surgery and its relationship with clinical follow-up from PET/CT performed at different weeks were evaluated. PET/CTs provided reliable data, such as areas showing abnormally high increases in uptake using a volumetric region of interest (VOI) comprising the upper (UP) and lower (DOWN) limits of the cage. Results: A total of 15 patients was selected for PET examination. Timing of PET/CTs ranged from one week to a maximum of 100 weeks after surgery. The analysis showed a negative correlation between the variables SUVmaxDOWN/time (r = −0.48, p = 0.04), ratio-DOWN/time (r = −0.53, p = 0.02), and ratio-MEAN/time (r = −0.5, p = 0.03). Shapiro−Wilk normality tests showed significant results for the variables ratio-DOWN (p = 0.002), ratio-UP (0.013), and ratio-MEAN (0.002). Conclusions: 18F-NaF PET/CT has proven to be a reliable tool for investigating the metabolic-reparative reaction following implantation of TTCs, demonstrating radiologically how this type of cage can induce reparative osteoblastic activity at the level of the vertebral endplate surface. This study further confirms how electron-beam melting (EBM)-molded titanium trabecular cages represent a promising material for reducing hardware complication rates and promoting fusion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Efficacy of Trabecular Titanium Cages to Induce Reparative Bone Activity after Lumbar Arthrodesis Studied through the 18f-Naf PET/CT Scan: Observational Clinical In-Vivo Study

et al. 2022

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“…Traditional imaging methods, such as CT or MRI, have low accuracy identifying metastatic lesions and have low diagnostic efficiency for early lymph node metastasis and distant metastasis. PET/CT technology combines the unique advantages of anatomy image and functional metabolism image so that doctors can obtain accurate anatomical positioning while understanding the biological metabolism information ( 21 ). Therefore, this method has important clinical significance for the diagnosis of PCa.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of 18F-DCFPyL PSMA PET/CT for Prostate Cancer: A Meta-Analysis

Pan

Wang

et al. 2021

Front. Oncol.

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BackgroundTo systematically review the clinical value of 18F-DCFPyL prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) in the diagnosis of prostate cancer (PCa).MethodsLiterature concerning 18F-DCFPyL PSMA PET/CT in the diagnosis of prostate cancer published from 2015 to 2020 was electronically searched in the databases including PubMed and Embase. Statistical analysis was carried out with STATA 15 software, and the quality of included studies was tested with quality assessment of diagnostic accuracy studies (QUADAS) items. The heterogeneity of the included data was tested.ResultsIn total, nine pieces of literature involving 426 patients met the inclusion criteria. The heterogeneity of the study group was not obvious. The SEN, SPE, LR+, LR−, DOR as well as AUC of 18F-DCFPyL PSMA PET/CT diagnosis of prostate cancer were 0.91, 0.90, 8.9, 0.10, 93, and 0.93. The pooled DR of 18F-DCFPyL labeled PSMA PET/CT in PCa was 92%. The pooled DR was 89% for PSA≥0.5 ng/ml and 49% for PSA < 0.5ng/ml.Conclusion18F-DCFPyL PSMA PET/CT had good sensitivity and specificity for the diagnosis of prostate cancer. The DR of 18F-DCFPyL PSMA PET/CT was correlated with PSA value. Further large-sample, high-quality studies were needed.

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“…Positron emission tomography (PET) shows the radioactivity of photons emitted by radiotracers [ 46 ]. Fluorine-18 sodium fluoride (18F-NaF) can evaluate the postoperative cervical spine; successful fusion has lower NaF uptake and less pain [ 47 ].…”

Section: Imaging Methodsmentioning

confidence: 99%

Imaging Assessment of the Postoperative Spine: An Updated Pictorial Review of Selected Complications

Corona-Cedillo

Saavedra-Navarrete

Espinoza-Garcia

et al. 2021

BioMed Research International

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Imaging of the postoperative spine requires the identification of several critical points by the radiologist to be written in the medical report: condition of the underlying cortical and cancellous bone, intervertebral disc, and musculoskeletal tissues; location and integrity of surgical implants; evaluation of the success of decompression procedures; delineation of fusion status; and identification of complications. This article presents a pictorial narrative review of the most common findings observed in noninstrumented and instrumented postoperative spines. Complications in the noninstrumented spine were grouped in early (hematomas, pseudomeningocele, and postoperative spine infection) and late findings (arachnoiditis, radiculitis, recurrent disc herniation, spinal stenosis, and textiloma). Complications in the instrumented spine were also sorted in early (hardware fractures) and late findings (adjacent segment disease, hardware loosening, and implant migration). This review also includes a short description of the most used diagnostic techniques in postoperative spine imaging: plain radiography, ultrasound (US), computed tomography (CT), magnetic resonance (MR), and nuclear medicine. Imaging of the postoperative spine remained a challenging task in the early identification of complications and abnormal healing process. It is crucial to consider the advantages and disadvantages of the imaging modalities to choose those that provide more accurate spinal status information during the follow-up. Our review is directed to all health professionals dealing with the assessment and care of the postoperative spine.

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Utility of 18F sodium fluoride PET/CT imaging in the evaluation of postoperative pain following surgical spine fusion

Abstract: 18F sodium fluoride PET/CT proves to be a useful tool in the diagnosis of complex spine pathology of the postoperative patients. In varied cases, a high correlation of metabolic activity to the source of the patient's pain was observed.

Cited by 9 publications

References 19 publications

The Efficacy of Trabecular Titanium Cages to Induce Reparative Bone Activity after Lumbar Arthrodesis Studied through the 18f-Naf PET/CT Scan: Observational Clinical In-Vivo Study

The Efficacy of Trabecular Titanium Cages to Induce Reparative Bone Activity after Lumbar Arthrodesis Studied through the 18f-Naf PET/CT Scan: Observational Clinical In-Vivo Study

Evaluation of 18F-DCFPyL PSMA PET/CT for Prostate Cancer: A Meta-Analysis

Imaging Assessment of the Postoperative Spine: An Updated Pictorial Review of Selected Complications

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