18F-sodium fluoride PET-CT visualizes disease activity in adult chronic nonbacterial osteitis (CNO)

IF 3.4 Q2 ENDOCRINOLOGY & METABOLISM JBMR Plus Pub Date : 2024-01-04 DOI:10.1093/jbmrpl/ziad007
A. Leerling, F. Smit, Zita Spӓth, Ana Navas Cañete, L. de Geus-Oei, A. van de Burgt, Olaf M Dekkers, W. van der Bruggen, Natasha M Appelman-Dijkstra, D. Vriens, Elizabeth M Winter
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Abstract

Chronic nonbacterial osteitis (CNO) is a rare disease spectrum, which lacks biomarkers for disease activity. Sodium fluoride positron emission tomography ([18F]NaF-PET/CT) is a sensitive imaging tool for bone diseases and yields quantitative data on bone turnover. We evaluate the capacities of [18F]NaF-PET/CT to provide structural and functional assessment in adult CNO. Cross-sectional study among 43 adult CNO patients and 16 controls (patients referred for suspected, but not diagnosed as CNO) undergoing [18F]NaF-PET/CT at our expert clinic. Structural features were compared between patients and controls, and maximal standardized uptake values (SUVmax (g/ml)) were calculated for bone lesions, soft tissue/joint lesions, and reference bone. SUVmax was correlated with clinical disease activity in patients. Manubrial and costal sclerosis/hyperostosis, and calcification of the costoclavicular ligament emerged core structural features associated with CNO as visualized by [18F]NaF-PET/CT. SUVmax of CNO lesions was higher compared to in-patient reference bone (mean paired difference 11.4, 95%CI9.4–13.5, p < 0.001) and controls (mean difference 12.4, 95%CI9.1–15.8, p < 0.001). Highest SUVmax values were found in soft tissue and joint areas like the costoclavicular ligament and manubriosternal joint, and these correlated with erythrocyte sedimentation rate in patients (correlation coefficient 0.546, p < 0.002). [18F]NaF-PET/CT is a promising imaging tool for adult CNO, allowing for detailed structural evaluation of its typical bone, soft-tissue and joint features. At the same time, [18F]NaF-PET/CT yields quantitative bone remodeling data that represent the pathologically increased bone turnover and the process of new bone formation. Further studies should investigate the application of quantified [18F]NaF-uptake as a novel biomarker for disease activity in CNO, and its utility to steer clinical decision-making.
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18F-氟化钠 PET-CT 显示成人慢性非细菌性骨炎 (CNO) 的疾病活动情况
慢性非细菌性骨炎(CNO)是一种罕见的疾病谱,缺乏疾病活动的生物标志物。氟化钠正电子发射断层扫描([18F]NaF-PET/CT)是一种灵敏的骨病成像工具,可获得骨转换的定量数据。我们评估了[18F]NaF-PET/CT 对成人 CNO 进行结构和功能评估的能力。 横断面研究的对象是在我们的专家诊所接受[18F]NaF-PET/CT检查的43名成年CNO患者和16名对照组患者(疑似CNO但未确诊的转诊患者)。比较了患者和对照组的结构特征,并计算了骨病变、软组织/关节病变和参考骨的最大标准化摄取值(SUVmax (g/ml))。SUVmax 与患者的临床疾病活动性相关。 通过[18F]NaF-PET/CT观察,Manubrial和肋骨硬化/骨质增生以及肋锁韧带钙化成为与CNO相关的核心结构特征。与住院参照骨(平均配对差异为11.4,95%CI9.4-13.5,p < 0.001)和对照组(平均差异为12.4,95%CI9.1-15.8,p < 0.001)相比,CNO病变的SUVmax更高。软组织和关节部位的 SUVmax 值最高,如肋锁韧带和人胸关节,这些部位与患者的红细胞沉降率相关(相关系数 0.546,P <0.002)。 [18F]NaF-PET/CT是一种很有前景的成人CNO成像工具,可对其典型的骨、软组织和关节特征进行详细的结构评估。同时,[18F]NaF-PET/CT 还能获得骨重塑的定量数据,反映病理上增加的骨转换和新骨形成的过程。进一步的研究应探讨将[18F]NaF-摄取定量作为一种新的生物标记物在 CNO 疾病活动中的应用,以及其在指导临床决策中的实用性。
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来源期刊
JBMR Plus
JBMR Plus Medicine-Orthopedics and Sports Medicine
CiteScore
5.80
自引率
2.60%
发文量
103
审稿时长
8 weeks
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