Limits...
High bone turnover assessed by 18F-fluoride PET/CT in the spine and sacroiliac joints of patients with ankylosing spondylitis: comparison with inflammatory lesions detected by whole body MRI.

Fischer DR, Pfirrmann CW, Zubler V, Stumpe KD, Seifert B, Strobel K, Tamborrini G, von Schulthess GK, Michel BA, Ciurea A - EJNMMI Res (2012)

Bottom Line: The corresponding kappa values for the MRI modality were 0.64 and 0.93, respectively.More spinal lesions were detected by MRI in comparison to PET/CT (68 vs. 38), whereas a similar number of SIJ quadrants scored positive in both modalities (19 vs. 17).Analysis of agreement of lesion detection between both imaging modalities yielded a kappa value of only 0.25 for spinal lesions and of 0.64 for SIJ lesions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland. dorothee.fischer@usz.ch.

ABSTRACT

Background: This study compares the frequency and distribution of increased activity on 18 F-fluoride PET/CT with the presence of bone marrow edema on whole-body MR imaging in the spine and sacroiliac joints (SIJ) of patients with active ankylosing spondylitis (AS).

Methods: Ten patients (6 men and 4 women), between 30 and 58 years old (median 44) with active AS, were prospectively examined with both whole-body MRI and 18 F-fluoride PET/CT. Patients fulfilled modified NY criteria and had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 4. Increased radiotracer uptake in PET/CT and bone marrow edema in whole-body MRI of spine and SIJ was evaluated independently by two blinded observers for each modality. Kappa statistics were used to compare interobserver agreement as well as scores of consensus reading of the two imaging modalities.

Results: Analysis of interobserver agreement for PET/CT yielded a kappa value of 0.68 for spinal lesions and of 0.88 for SIJ lesions. The corresponding kappa values for the MRI modality were 0.64 and 0.93, respectively. More spinal lesions were detected by MRI in comparison to PET/CT (68 vs. 38), whereas a similar number of SIJ quadrants scored positive in both modalities (19 vs. 17). Analysis of agreement of lesion detection between both imaging modalities yielded a kappa value of only 0.25 for spinal lesions and of 0.64 for SIJ lesions.

Conclusion: Increased 18 F-fluoride uptake in PET/CT is only modestly associated with bone marrow edema on MRI in the spine and SIJ of patients with AS, suggesting different aspects of bone involvement in AS.

No MeSH data available.


Related in: MedlinePlus

Thirty-year-old female patient (patient number 5). Patient with positive findings in all four inferior iliosacral quadrants both on MRI and F PET/CT without exact overlap. Axial STIR images (left) and fused PET/CT images (right).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3472173&req=5

Figure 4: Thirty-year-old female patient (patient number 5). Patient with positive findings in all four inferior iliosacral quadrants both on MRI and F PET/CT without exact overlap. Axial STIR images (left) and fused PET/CT images (right).

Mentions: A better agreement between the two imaging methods was found for inflammation in SIJ quadrants (kappa value 0.64): 13/80 SIJ quadrants had lesions recorded by both methods, while 4 lesions were detected only by F PET/CT, and 6 only by MRI (Table 4, Figure 3). However, the evaluated SIJ quadrants were quite large, and retrospective comparison of the changes of SIJ quadrants in both modalities showed that in the SIJ edema and increased 18 F-fluoride uptake, although situated in the same quadrants, did not all show an exact overlap (Figure 4).


High bone turnover assessed by 18F-fluoride PET/CT in the spine and sacroiliac joints of patients with ankylosing spondylitis: comparison with inflammatory lesions detected by whole body MRI.

Fischer DR, Pfirrmann CW, Zubler V, Stumpe KD, Seifert B, Strobel K, Tamborrini G, von Schulthess GK, Michel BA, Ciurea A - EJNMMI Res (2012)

Thirty-year-old female patient (patient number 5). Patient with positive findings in all four inferior iliosacral quadrants both on MRI and F PET/CT without exact overlap. Axial STIR images (left) and fused PET/CT images (right).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472173&req=5

Figure 4: Thirty-year-old female patient (patient number 5). Patient with positive findings in all four inferior iliosacral quadrants both on MRI and F PET/CT without exact overlap. Axial STIR images (left) and fused PET/CT images (right).
Mentions: A better agreement between the two imaging methods was found for inflammation in SIJ quadrants (kappa value 0.64): 13/80 SIJ quadrants had lesions recorded by both methods, while 4 lesions were detected only by F PET/CT, and 6 only by MRI (Table 4, Figure 3). However, the evaluated SIJ quadrants were quite large, and retrospective comparison of the changes of SIJ quadrants in both modalities showed that in the SIJ edema and increased 18 F-fluoride uptake, although situated in the same quadrants, did not all show an exact overlap (Figure 4).

Bottom Line: The corresponding kappa values for the MRI modality were 0.64 and 0.93, respectively.More spinal lesions were detected by MRI in comparison to PET/CT (68 vs. 38), whereas a similar number of SIJ quadrants scored positive in both modalities (19 vs. 17).Analysis of agreement of lesion detection between both imaging modalities yielded a kappa value of only 0.25 for spinal lesions and of 0.64 for SIJ lesions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland. dorothee.fischer@usz.ch.

ABSTRACT

Background: This study compares the frequency and distribution of increased activity on 18 F-fluoride PET/CT with the presence of bone marrow edema on whole-body MR imaging in the spine and sacroiliac joints (SIJ) of patients with active ankylosing spondylitis (AS).

Methods: Ten patients (6 men and 4 women), between 30 and 58 years old (median 44) with active AS, were prospectively examined with both whole-body MRI and 18 F-fluoride PET/CT. Patients fulfilled modified NY criteria and had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 4. Increased radiotracer uptake in PET/CT and bone marrow edema in whole-body MRI of spine and SIJ was evaluated independently by two blinded observers for each modality. Kappa statistics were used to compare interobserver agreement as well as scores of consensus reading of the two imaging modalities.

Results: Analysis of interobserver agreement for PET/CT yielded a kappa value of 0.68 for spinal lesions and of 0.88 for SIJ lesions. The corresponding kappa values for the MRI modality were 0.64 and 0.93, respectively. More spinal lesions were detected by MRI in comparison to PET/CT (68 vs. 38), whereas a similar number of SIJ quadrants scored positive in both modalities (19 vs. 17). Analysis of agreement of lesion detection between both imaging modalities yielded a kappa value of only 0.25 for spinal lesions and of 0.64 for SIJ lesions.

Conclusion: Increased 18 F-fluoride uptake in PET/CT is only modestly associated with bone marrow edema on MRI in the spine and SIJ of patients with AS, suggesting different aspects of bone involvement in AS.

No MeSH data available.


Related in: MedlinePlus