Can Spatiotemporal Fluoride (18F−) Uptake be Used to Assess Bone Formation in the Tibia? A Longitudinal Study Using PET/CT
Background When a bone is broken for any reason, it is important for the orthopaedic surgeon to know how bone healing is progressing. There has been resurgence in the use of the fluoride ( 18 F − ) ion to evaluate various bone conditions. This has been made possible by availability of positron emiss...
Gespeichert in:
| Veröffentlicht in: | Clinical orthopaedics and related research 2017-05, Vol.475 (5), p.1486-1498 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1498 |
|---|---|
| container_issue | 5 |
| container_start_page | 1486 |
| container_title | Clinical orthopaedics and related research |
| container_volume | 475 |
| creator | Lundblad, Henrik Karlsson-Thur, Charlotte Maguire, Gerald Q. Jonsson, Cathrine Noz, Marilyn E. Zeleznik, Michael P. Weidenhielm, Lars |
| description | Background
When a bone is broken for any reason, it is important for the orthopaedic surgeon to know how bone healing is progressing. There has been resurgence in the use of the fluoride (
18
F
−
) ion to evaluate various bone conditions. This has been made possible by availability of positron emission tomography (PET)/CT hybrid scanners together with cyclotrons. Absorbed on the bone surface from blood flow,
18
F
−
attaches to the osteoblasts in cancellous bone and acts as a pharmacokinetic agent, which reflects the local physiologic activity of bone. This is important because it shows bone formation indicating that the bone is healing or no bone formation indicating no healing. As
18
F
−
is extracted from blood in proportion to blood flow and bone formation, it thus enables determination of bone healing progress.
Questions/purposes
The primary objective of this study was to determine whether videos showing the spatiotemporal uptake of
18
F
−
via PET bone scans could show problematic bone healing in patients with complex tibia conditions. A secondary objective was to determine if semiquantification of radionuclide uptake was consistent with bone healing.
Methods
This study investigated measurements of tibia bone formation in patients with complex fractures, osteomyelitis, and osteotomies treated with a Taylor Spatial Frame
TM
(TSF) by comparing clinical healing progress with spatiotemporal fluoride (
18
F
−
) uptake and the semiquantitative standardized uptake value (SUV). This procedure included static and dynamic image acquisition. For intrapatient volumes acquired at different times, the CT and PET data were spatially registered to bring the ends of the bones that were supposed to heal into alignment. To qualitatively observe how and where bone formation was occurring, time-sequenced volumes were reconstructed and viewed as a video. To semiquantify the uptake, the mean and maximum SUVs (SUVmean, SUVmax) were calculated for the ends of the bones that were supposed to heal and for normal bone, using a spherical volume of interest drawn on the registered volumes. To make the semiquantitative data comparable for all patients with multiple examinations, the SUVmean and SUVmax difference per day (SUVmeanDPD and SUVmaxDPD) between the first PET/CT scan and each subsequent one was calculated. Indicators of poor healing progress were (1) uneven distribution of the radionuclide uptake between ends of the bones that were supposed to heal as seen in the video or, ( |
| doi_str_mv | 10.1007/s11999-017-5250-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_499362</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1865537448</sourcerecordid><originalsourceid>FETCH-LOGICAL-c546t-cca3343816f9cbcbdf7162051a84bf82d5753339944d1dc93d9a8fb44c00d3563</originalsourceid><addsrcrecordid>eNp9kstu1DAUhiMEokPhAdggS2zKItTXxN5QDUMHkEYCqTOIneUkTsadxA520qoSD8CaR-RJcDRD1SLByrfPn4-P_iR5juBrBGF-GhASQqQQ5SnDDKb8QTJDDPMUIYIfJjMIoUgFRl-PkichXMYloQw_To4wRwxinM2S7wtlwUWvBuMG3fXOqxYs29F5U2lwgvjy14-fr8CmH9ROg0KDTdAVGByYh6BDAG-d1WDpfDcJLDAWDFsN1qYw6gzMwcrZxgxjZWzUXsTJTRQY24DP5-vTxfpp8qhWbdDPDuNxslmerxcf0tWn9x8X81VaMpoNaVkqQijhKKtFWZRFVecow5AhxWlRc1yxnBFChKC0QlUpSCUUrwtKSwgrwjJynKR7b7jW_VjI3ptO-RvplJGHrV2caUmFIBn-L__OfJlL5xu5G7YyFoEJjPybPR_hTleltkPs471r90-s2crGXUlGOBVYRMHJQeDdt1GHQXYmlLptldVuDBLxjDGSU8oj-vIv9NKNPvZ3ojhDXLBsqgjtqdK7ELyub4tBUE7ZkfvsyJgdOWVHTuYXd39xe-NPWCKAD22JR7bR_s7T_7T-Bhawz6o</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1885189560</pqid></control><display><type>article</type><title>Can Spatiotemporal Fluoride (18F−) Uptake be Used to Assess Bone Formation in the Tibia? A Longitudinal Study Using PET/CT</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>SWEPUB Freely available online</source><creator>Lundblad, Henrik ; Karlsson-Thur, Charlotte ; Maguire, Gerald Q. ; Jonsson, Cathrine ; Noz, Marilyn E. ; Zeleznik, Michael P. ; Weidenhielm, Lars</creator><creatorcontrib>Lundblad, Henrik ; Karlsson-Thur, Charlotte ; Maguire, Gerald Q. ; Jonsson, Cathrine ; Noz, Marilyn E. ; Zeleznik, Michael P. ; Weidenhielm, Lars</creatorcontrib><description>Background
When a bone is broken for any reason, it is important for the orthopaedic surgeon to know how bone healing is progressing. There has been resurgence in the use of the fluoride (
18
F
−
) ion to evaluate various bone conditions. This has been made possible by availability of positron emission tomography (PET)/CT hybrid scanners together with cyclotrons. Absorbed on the bone surface from blood flow,
18
F
−
attaches to the osteoblasts in cancellous bone and acts as a pharmacokinetic agent, which reflects the local physiologic activity of bone. This is important because it shows bone formation indicating that the bone is healing or no bone formation indicating no healing. As
18
F
−
is extracted from blood in proportion to blood flow and bone formation, it thus enables determination of bone healing progress.
Questions/purposes
The primary objective of this study was to determine whether videos showing the spatiotemporal uptake of
18
F
−
via PET bone scans could show problematic bone healing in patients with complex tibia conditions. A secondary objective was to determine if semiquantification of radionuclide uptake was consistent with bone healing.
Methods
This study investigated measurements of tibia bone formation in patients with complex fractures, osteomyelitis, and osteotomies treated with a Taylor Spatial Frame
TM
(TSF) by comparing clinical healing progress with spatiotemporal fluoride (
18
F
−
) uptake and the semiquantitative standardized uptake value (SUV). This procedure included static and dynamic image acquisition. For intrapatient volumes acquired at different times, the CT and PET data were spatially registered to bring the ends of the bones that were supposed to heal into alignment. To qualitatively observe how and where bone formation was occurring, time-sequenced volumes were reconstructed and viewed as a video. To semiquantify the uptake, the mean and maximum SUVs (SUVmean, SUVmax) were calculated for the ends of the bones that were supposed to heal and for normal bone, using a spherical volume of interest drawn on the registered volumes. To make the semiquantitative data comparable for all patients with multiple examinations, the SUVmean and SUVmax difference per day (SUVmeanDPD and SUVmaxDPD) between the first PET/CT scan and each subsequent one was calculated. Indicators of poor healing progress were (1) uneven distribution of the radionuclide uptake between ends of the bones that were supposed to heal as seen in the video or, (2) low absolute magnitude of the SUV difference data. Twenty-four patients treated between October 2013 and April 2015 with a TSF gave informed consent to be examined with
18
F
−
PET/CT bone scans. Twenty-two patients successfully completed treatment, one of whom had only one PET/CT scan.
Results
Observation of
18
F
−
uptake was able to identify three patients whose healing progress was poor, indicated by uneven distribution of radionuclide uptake across the ends of the bones that were supposed to heal. An absolute magnitude of the SUVmaxDPD of 0.18 or greater indicated good bone formation progress. This was verified in 10 patients by the days between the operation to attach and to remove the TSF being less than 250 days, whereas other SUVmaxDPD values were ambiguous, with 11 patients achieving successful completion.
Conclusions
Observation of the spatiotemporal uptake of
18
F
−
appears to be a promising method to enable the clinician to assess the progress of bone formation in different parts of the bone. Bone uptake which is uneven across the ends of bone that were supposed to heal or very low bone uptake might indicate impaired bone healing where early intervention may then be needed. However, semiquantification of
18
F
−
uptake (SUVmaxDPD), SUVmeanDPD) was ambiguous in showing consistency with the bone-healing progress.
Level of Evidence
Level III, diagnostic study.</description><identifier>ISSN: 0009-921X</identifier><identifier>ISSN: 1528-1132</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1007/s11999-017-5250-8</identifier><identifier>PMID: 28150226</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Aged ; Clinical Research ; Conservative Orthopedics ; External Fixators ; Female ; Fluorine Radioisotopes - administration & dosage ; Fracture Fixation - instrumentation ; Fracture Healing ; Humans ; Knee ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Osteogenesis ; Osteomyelitis - diagnostic imaging ; Osteomyelitis - physiopathology ; Osteomyelitis - surgery ; Osteotomy ; Positron Emission Tomography Computed Tomography ; Predictive Value of Tests ; Radiopharmaceuticals - administration & dosage ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Tibial Fractures - diagnostic imaging ; Tibial Fractures - physiopathology ; Tibial Fractures - surgery ; Time Factors ; Treatment Outcome ; Young Adult</subject><ispartof>Clinical orthopaedics and related research, 2017-05, Vol.475 (5), p.1486-1498</ispartof><rights>The Author(s) 2017</rights><rights>Clinical Orthopaedics and Related Research is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c546t-cca3343816f9cbcbdf7162051a84bf82d5753339944d1dc93d9a8fb44c00d3563</citedby><cites>FETCH-LOGICAL-c546t-cca3343816f9cbcbdf7162051a84bf82d5753339944d1dc93d9a8fb44c00d3563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384929/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384929/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28150226$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-205230$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:135618521$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Lundblad, Henrik</creatorcontrib><creatorcontrib>Karlsson-Thur, Charlotte</creatorcontrib><creatorcontrib>Maguire, Gerald Q.</creatorcontrib><creatorcontrib>Jonsson, Cathrine</creatorcontrib><creatorcontrib>Noz, Marilyn E.</creatorcontrib><creatorcontrib>Zeleznik, Michael P.</creatorcontrib><creatorcontrib>Weidenhielm, Lars</creatorcontrib><title>Can Spatiotemporal Fluoride (18F−) Uptake be Used to Assess Bone Formation in the Tibia? A Longitudinal Study Using PET/CT</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><addtitle>Clin Orthop Relat Res</addtitle><description>Background
When a bone is broken for any reason, it is important for the orthopaedic surgeon to know how bone healing is progressing. There has been resurgence in the use of the fluoride (
18
F
−
) ion to evaluate various bone conditions. This has been made possible by availability of positron emission tomography (PET)/CT hybrid scanners together with cyclotrons. Absorbed on the bone surface from blood flow,
18
F
−
attaches to the osteoblasts in cancellous bone and acts as a pharmacokinetic agent, which reflects the local physiologic activity of bone. This is important because it shows bone formation indicating that the bone is healing or no bone formation indicating no healing. As
18
F
−
is extracted from blood in proportion to blood flow and bone formation, it thus enables determination of bone healing progress.
Questions/purposes
The primary objective of this study was to determine whether videos showing the spatiotemporal uptake of
18
F
−
via PET bone scans could show problematic bone healing in patients with complex tibia conditions. A secondary objective was to determine if semiquantification of radionuclide uptake was consistent with bone healing.
Methods
This study investigated measurements of tibia bone formation in patients with complex fractures, osteomyelitis, and osteotomies treated with a Taylor Spatial Frame
TM
(TSF) by comparing clinical healing progress with spatiotemporal fluoride (
18
F
−
) uptake and the semiquantitative standardized uptake value (SUV). This procedure included static and dynamic image acquisition. For intrapatient volumes acquired at different times, the CT and PET data were spatially registered to bring the ends of the bones that were supposed to heal into alignment. To qualitatively observe how and where bone formation was occurring, time-sequenced volumes were reconstructed and viewed as a video. To semiquantify the uptake, the mean and maximum SUVs (SUVmean, SUVmax) were calculated for the ends of the bones that were supposed to heal and for normal bone, using a spherical volume of interest drawn on the registered volumes. To make the semiquantitative data comparable for all patients with multiple examinations, the SUVmean and SUVmax difference per day (SUVmeanDPD and SUVmaxDPD) between the first PET/CT scan and each subsequent one was calculated. Indicators of poor healing progress were (1) uneven distribution of the radionuclide uptake between ends of the bones that were supposed to heal as seen in the video or, (2) low absolute magnitude of the SUV difference data. Twenty-four patients treated between October 2013 and April 2015 with a TSF gave informed consent to be examined with
18
F
−
PET/CT bone scans. Twenty-two patients successfully completed treatment, one of whom had only one PET/CT scan.
Results
Observation of
18
F
−
uptake was able to identify three patients whose healing progress was poor, indicated by uneven distribution of radionuclide uptake across the ends of the bones that were supposed to heal. An absolute magnitude of the SUVmaxDPD of 0.18 or greater indicated good bone formation progress. This was verified in 10 patients by the days between the operation to attach and to remove the TSF being less than 250 days, whereas other SUVmaxDPD values were ambiguous, with 11 patients achieving successful completion.
Conclusions
Observation of the spatiotemporal uptake of
18
F
−
appears to be a promising method to enable the clinician to assess the progress of bone formation in different parts of the bone. Bone uptake which is uneven across the ends of bone that were supposed to heal or very low bone uptake might indicate impaired bone healing where early intervention may then be needed. However, semiquantification of
18
F
−
uptake (SUVmaxDPD), SUVmeanDPD) was ambiguous in showing consistency with the bone-healing progress.
Level of Evidence
Level III, diagnostic study.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Clinical Research</subject><subject>Conservative Orthopedics</subject><subject>External Fixators</subject><subject>Female</subject><subject>Fluorine Radioisotopes - administration & dosage</subject><subject>Fracture Fixation - instrumentation</subject><subject>Fracture Healing</subject><subject>Humans</subject><subject>Knee</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Osteogenesis</subject><subject>Osteomyelitis - diagnostic imaging</subject><subject>Osteomyelitis - physiopathology</subject><subject>Osteomyelitis - surgery</subject><subject>Osteotomy</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Predictive Value of Tests</subject><subject>Radiopharmaceuticals - administration & dosage</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Tibial Fractures - diagnostic imaging</subject><subject>Tibial Fractures - physiopathology</subject><subject>Tibial Fractures - surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0009-921X</issn><issn>1528-1132</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>D8T</sourceid><recordid>eNp9kstu1DAUhiMEokPhAdggS2zKItTXxN5QDUMHkEYCqTOIneUkTsadxA520qoSD8CaR-RJcDRD1SLByrfPn4-P_iR5juBrBGF-GhASQqQQ5SnDDKb8QTJDDPMUIYIfJjMIoUgFRl-PkichXMYloQw_To4wRwxinM2S7wtlwUWvBuMG3fXOqxYs29F5U2lwgvjy14-fr8CmH9ROg0KDTdAVGByYh6BDAG-d1WDpfDcJLDAWDFsN1qYw6gzMwcrZxgxjZWzUXsTJTRQY24DP5-vTxfpp8qhWbdDPDuNxslmerxcf0tWn9x8X81VaMpoNaVkqQijhKKtFWZRFVecow5AhxWlRc1yxnBFChKC0QlUpSCUUrwtKSwgrwjJynKR7b7jW_VjI3ptO-RvplJGHrV2caUmFIBn-L__OfJlL5xu5G7YyFoEJjPybPR_hTleltkPs471r90-s2crGXUlGOBVYRMHJQeDdt1GHQXYmlLptldVuDBLxjDGSU8oj-vIv9NKNPvZ3ojhDXLBsqgjtqdK7ELyub4tBUE7ZkfvsyJgdOWVHTuYXd39xe-NPWCKAD22JR7bR_s7T_7T-Bhawz6o</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Lundblad, Henrik</creator><creator>Karlsson-Thur, Charlotte</creator><creator>Maguire, Gerald Q.</creator><creator>Jonsson, Cathrine</creator><creator>Noz, Marilyn E.</creator><creator>Zeleznik, Michael P.</creator><creator>Weidenhielm, Lars</creator><general>Springer US</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AFDQA</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D8V</scope><scope>ZZAVC</scope></search><sort><creationdate>20170501</creationdate><title>Can Spatiotemporal Fluoride (18F−) Uptake be Used to Assess Bone Formation in the Tibia? A Longitudinal Study Using PET/CT</title><author>Lundblad, Henrik ; Karlsson-Thur, Charlotte ; Maguire, Gerald Q. ; Jonsson, Cathrine ; Noz, Marilyn E. ; Zeleznik, Michael P. ; Weidenhielm, Lars</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c546t-cca3343816f9cbcbdf7162051a84bf82d5753339944d1dc93d9a8fb44c00d3563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Clinical Research</topic><topic>Conservative Orthopedics</topic><topic>External Fixators</topic><topic>Female</topic><topic>Fluorine Radioisotopes - administration & dosage</topic><topic>Fracture Fixation - instrumentation</topic><topic>Fracture Healing</topic><topic>Humans</topic><topic>Knee</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Osteogenesis</topic><topic>Osteomyelitis - diagnostic imaging</topic><topic>Osteomyelitis - physiopathology</topic><topic>Osteomyelitis - surgery</topic><topic>Osteotomy</topic><topic>Positron Emission Tomography Computed Tomography</topic><topic>Predictive Value of Tests</topic><topic>Radiopharmaceuticals - administration & dosage</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Tibial Fractures - diagnostic imaging</topic><topic>Tibial Fractures - physiopathology</topic><topic>Tibial Fractures - surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lundblad, Henrik</creatorcontrib><creatorcontrib>Karlsson-Thur, Charlotte</creatorcontrib><creatorcontrib>Maguire, Gerald Q.</creatorcontrib><creatorcontrib>Jonsson, Cathrine</creatorcontrib><creatorcontrib>Noz, Marilyn E.</creatorcontrib><creatorcontrib>Zeleznik, Michael P.</creatorcontrib><creatorcontrib>Weidenhielm, Lars</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SWEPUB Kungliga Tekniska Högskolan full text</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Kungliga Tekniska Högskolan</collection><collection>SwePub Articles full text</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lundblad, Henrik</au><au>Karlsson-Thur, Charlotte</au><au>Maguire, Gerald Q.</au><au>Jonsson, Cathrine</au><au>Noz, Marilyn E.</au><au>Zeleznik, Michael P.</au><au>Weidenhielm, Lars</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can Spatiotemporal Fluoride (18F−) Uptake be Used to Assess Bone Formation in the Tibia? A Longitudinal Study Using PET/CT</atitle><jtitle>Clinical orthopaedics and related research</jtitle><stitle>Clin Orthop Relat Res</stitle><addtitle>Clin Orthop Relat Res</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>475</volume><issue>5</issue><spage>1486</spage><epage>1498</epage><pages>1486-1498</pages><issn>0009-921X</issn><issn>1528-1132</issn><eissn>1528-1132</eissn><abstract>Background
When a bone is broken for any reason, it is important for the orthopaedic surgeon to know how bone healing is progressing. There has been resurgence in the use of the fluoride (
18
F
−
) ion to evaluate various bone conditions. This has been made possible by availability of positron emission tomography (PET)/CT hybrid scanners together with cyclotrons. Absorbed on the bone surface from blood flow,
18
F
−
attaches to the osteoblasts in cancellous bone and acts as a pharmacokinetic agent, which reflects the local physiologic activity of bone. This is important because it shows bone formation indicating that the bone is healing or no bone formation indicating no healing. As
18
F
−
is extracted from blood in proportion to blood flow and bone formation, it thus enables determination of bone healing progress.
Questions/purposes
The primary objective of this study was to determine whether videos showing the spatiotemporal uptake of
18
F
−
via PET bone scans could show problematic bone healing in patients with complex tibia conditions. A secondary objective was to determine if semiquantification of radionuclide uptake was consistent with bone healing.
Methods
This study investigated measurements of tibia bone formation in patients with complex fractures, osteomyelitis, and osteotomies treated with a Taylor Spatial Frame
TM
(TSF) by comparing clinical healing progress with spatiotemporal fluoride (
18
F
−
) uptake and the semiquantitative standardized uptake value (SUV). This procedure included static and dynamic image acquisition. For intrapatient volumes acquired at different times, the CT and PET data were spatially registered to bring the ends of the bones that were supposed to heal into alignment. To qualitatively observe how and where bone formation was occurring, time-sequenced volumes were reconstructed and viewed as a video. To semiquantify the uptake, the mean and maximum SUVs (SUVmean, SUVmax) were calculated for the ends of the bones that were supposed to heal and for normal bone, using a spherical volume of interest drawn on the registered volumes. To make the semiquantitative data comparable for all patients with multiple examinations, the SUVmean and SUVmax difference per day (SUVmeanDPD and SUVmaxDPD) between the first PET/CT scan and each subsequent one was calculated. Indicators of poor healing progress were (1) uneven distribution of the radionuclide uptake between ends of the bones that were supposed to heal as seen in the video or, (2) low absolute magnitude of the SUV difference data. Twenty-four patients treated between October 2013 and April 2015 with a TSF gave informed consent to be examined with
18
F
−
PET/CT bone scans. Twenty-two patients successfully completed treatment, one of whom had only one PET/CT scan.
Results
Observation of
18
F
−
uptake was able to identify three patients whose healing progress was poor, indicated by uneven distribution of radionuclide uptake across the ends of the bones that were supposed to heal. An absolute magnitude of the SUVmaxDPD of 0.18 or greater indicated good bone formation progress. This was verified in 10 patients by the days between the operation to attach and to remove the TSF being less than 250 days, whereas other SUVmaxDPD values were ambiguous, with 11 patients achieving successful completion.
Conclusions
Observation of the spatiotemporal uptake of
18
F
−
appears to be a promising method to enable the clinician to assess the progress of bone formation in different parts of the bone. Bone uptake which is uneven across the ends of bone that were supposed to heal or very low bone uptake might indicate impaired bone healing where early intervention may then be needed. However, semiquantification of
18
F
−
uptake (SUVmaxDPD), SUVmeanDPD) was ambiguous in showing consistency with the bone-healing progress.
Level of Evidence
Level III, diagnostic study.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28150226</pmid><doi>10.1007/s11999-017-5250-8</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0009-921X |
| ispartof | Clinical orthopaedics and related research, 2017-05, Vol.475 (5), p.1486-1498 |
| issn | 0009-921X 1528-1132 1528-1132 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_499362 |
| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; SWEPUB Freely available online |
| subjects | Adolescent Adult Aged Clinical Research Conservative Orthopedics External Fixators Female Fluorine Radioisotopes - administration & dosage Fracture Fixation - instrumentation Fracture Healing Humans Knee Longitudinal Studies Male Medicine Medicine & Public Health Middle Aged Orthopedics Osteogenesis Osteomyelitis - diagnostic imaging Osteomyelitis - physiopathology Osteomyelitis - surgery Osteotomy Positron Emission Tomography Computed Tomography Predictive Value of Tests Radiopharmaceuticals - administration & dosage Sports Medicine Surgery Surgical Orthopedics Tibial Fractures - diagnostic imaging Tibial Fractures - physiopathology Tibial Fractures - surgery Time Factors Treatment Outcome Young Adult |
| title | Can Spatiotemporal Fluoride (18F−) Uptake be Used to Assess Bone Formation in the Tibia? A Longitudinal Study Using PET/CT |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T00%3A47%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Can%20Spatiotemporal%20Fluoride%20(18F%E2%88%92)%20Uptake%20be%20Used%20to%20Assess%20Bone%20Formation%20in%20the%20Tibia?%20A%20Longitudinal%20Study%20Using%20PET/CT&rft.jtitle=Clinical%20orthopaedics%20and%20related%20research&rft.au=Lundblad,%20Henrik&rft.date=2017-05-01&rft.volume=475&rft.issue=5&rft.spage=1486&rft.epage=1498&rft.pages=1486-1498&rft.issn=0009-921X&rft.eissn=1528-1132&rft_id=info:doi/10.1007/s11999-017-5250-8&rft_dat=%3Cproquest_swepu%3E1865537448%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1885189560&rft_id=info:pmid/28150226&rfr_iscdi=true |