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(18)F-fluoride positron emission tomography measurements of regional bone formation in hemodialysis patients with suspected adynamic bone disease.

Frost ML, Compston JE, Goldsmith D, Moore AE, Blake GM, Siddique M, Skingle L, Fogelman I - Calcif. Tissue Int. (2013)

Bottom Line: There were no significant differences in K i between the two study groups or between the two subjects with ABD and the other CKD5D subjects at any skeletal ROI.When biopsies with single labels were excluded, a significant correlation was observed between K i/BMAD and MAR (r = 0.81, p = 0.008) but not BFR/BS.Further studies are required to establish the sensitivity of (18)F-PET as a diagnostic tool for identifying CKD patients with ABD.

View Article: PubMed Central - PubMed

Affiliation: Osteoporosis Unit, Division of Imaging Sciences and Biomedical Engineering, King's College London, Guy's Hospital Campus, Great Maze Pond, London, SE1 9RT, UK, michelle.frost@kcl.ac.uk.

ABSTRACT
(18)F-fluoride positron emission tomography ((18)F-PET) allows the assessment of regional bone formation and could have a role in the diagnosis of adynamic bone disease (ABD) in patients with chronic kidney disease (CKD). The purpose of this study was to examine bone formation at multiple sites of the skeleton in hemodialysis patients (CKD5D) and assess the correlation with bone biopsy. Seven CKD5D patients with suspected ABD and 12 osteoporotic postmenopausal women underwent an (18)F-PET scan, and bone plasma clearance, K i, was measured at ten skeletal regions of interest (ROI). Fifteen subjects had a transiliac bone biopsy following double tetracycline labeling. Two CKD5D patients had ABD confirmed by biopsy. There was significant heterogeneity in K i between skeletal sites, ranging from 0.008 at the forearm to 0.028 mL/min/mL at the spine in the CKD5D group. There were no significant differences in K i between the two study groups or between the two subjects with ABD and the other CKD5D subjects at any skeletal ROI. Five biopsies from the CKD5D patients had single tetracycline labels only, including the two with ABD. Using an imputed value of 0.3 Ī¼m/day for mineral apposition rate (MAR) for biopsies with single labels, no significant correlations were observed between lumbar spine K i corrected for BMAD (K i/BMAD) and bone formation rate (BFR/BS), or MAR. When biopsies with single labels were excluded, a significant correlation was observed between K i/BMAD and MAR (r = 0.81, p = 0.008) but not BFR/BS. Further studies are required to establish the sensitivity of (18)F-PET as a diagnostic tool for identifying CKD patients with ABD.

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18F-PET measurements of Ki at multiple skeletal sites. Significant differences in Ki between different skeletal sites were observed for both the CKD5D (pĀ <Ā 0.001) and osteoporosis (pĀ <Ā 0.001) groups. No significant differences were observed between the CKD5D and osteoporosis groups for mean Ki at each skeletal site
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Fig2: 18F-PET measurements of Ki at multiple skeletal sites. Significant differences in Ki between different skeletal sites were observed for both the CKD5D (pĀ <Ā 0.001) and osteoporosis (pĀ <Ā 0.001) groups. No significant differences were observed between the CKD5D and osteoporosis groups for mean Ki at each skeletal site

Mentions: Qualitative assessment of the individual 18F-fluoride whole-body scans for all subjects did not show any discernible differences in image quality or skeletal uptake of 18F-fluoride between those in the CKD5D and osteoporosis groups (Fig.Ā 1), including the two CKD5D subjects with ABD. Mean 18F-PET measurements of bone formation (the plasma clearance of 18F-fluoride to bone, Ki) at all measured skeletal sites for each of the study groups are shown in Fig.Ā 2. Individual and mean values of Ki for the CKD5D group at the main skeletal sites are compared with mean values for those with osteoporosis in TableĀ 3. There was significant heterogeneity in bone formation between skeletal sites for both study groups (TableĀ 3; Fig.Ā 2) that was confirmed statistically (Friedmanā€™s two-way analysis of variance pĀ <Ā 0.001 for both the CKD5D and osteoporosis groups). The pattern of skeletal heterogeneity was similar between the two groups (Fig.Ā 2). At each skeletal ROI no significant difference in Ki between the CKD5D and osteoporosis groups was found. The variability (and range) of individual Ki results tended to be greater in the CKD5D group, as demonstrated by the higher SD values compared to those obtained for the osteoporosis group. Focusing on CKD5D subjects 2 and 5 with confirmed ABD, subject 2 had the lowest values of Ki at the lumbar spine, total hip, and pelvis and the second lowest results at the humerus, forearm, and BMAD-corrected Ki values at the lumbar spine; subject 5 had the highest values of Ki at the lumbar spine and the second highest at nonspine sites (TableĀ 3).Fig.Ā 1


(18)F-fluoride positron emission tomography measurements of regional bone formation in hemodialysis patients with suspected adynamic bone disease.

Frost ML, Compston JE, Goldsmith D, Moore AE, Blake GM, Siddique M, Skingle L, Fogelman I - Calcif. Tissue Int. (2013)

18F-PET measurements of Ki at multiple skeletal sites. Significant differences in Ki between different skeletal sites were observed for both the CKD5D (pĀ <Ā 0.001) and osteoporosis (pĀ <Ā 0.001) groups. No significant differences were observed between the CKD5D and osteoporosis groups for mean Ki at each skeletal site
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3824308&req=5

Fig2: 18F-PET measurements of Ki at multiple skeletal sites. Significant differences in Ki between different skeletal sites were observed for both the CKD5D (pĀ <Ā 0.001) and osteoporosis (pĀ <Ā 0.001) groups. No significant differences were observed between the CKD5D and osteoporosis groups for mean Ki at each skeletal site
Mentions: Qualitative assessment of the individual 18F-fluoride whole-body scans for all subjects did not show any discernible differences in image quality or skeletal uptake of 18F-fluoride between those in the CKD5D and osteoporosis groups (Fig.Ā 1), including the two CKD5D subjects with ABD. Mean 18F-PET measurements of bone formation (the plasma clearance of 18F-fluoride to bone, Ki) at all measured skeletal sites for each of the study groups are shown in Fig.Ā 2. Individual and mean values of Ki for the CKD5D group at the main skeletal sites are compared with mean values for those with osteoporosis in TableĀ 3. There was significant heterogeneity in bone formation between skeletal sites for both study groups (TableĀ 3; Fig.Ā 2) that was confirmed statistically (Friedmanā€™s two-way analysis of variance pĀ <Ā 0.001 for both the CKD5D and osteoporosis groups). The pattern of skeletal heterogeneity was similar between the two groups (Fig.Ā 2). At each skeletal ROI no significant difference in Ki between the CKD5D and osteoporosis groups was found. The variability (and range) of individual Ki results tended to be greater in the CKD5D group, as demonstrated by the higher SD values compared to those obtained for the osteoporosis group. Focusing on CKD5D subjects 2 and 5 with confirmed ABD, subject 2 had the lowest values of Ki at the lumbar spine, total hip, and pelvis and the second lowest results at the humerus, forearm, and BMAD-corrected Ki values at the lumbar spine; subject 5 had the highest values of Ki at the lumbar spine and the second highest at nonspine sites (TableĀ 3).Fig.Ā 1

Bottom Line: There were no significant differences in K i between the two study groups or between the two subjects with ABD and the other CKD5D subjects at any skeletal ROI.When biopsies with single labels were excluded, a significant correlation was observed between K i/BMAD and MAR (r = 0.81, p = 0.008) but not BFR/BS.Further studies are required to establish the sensitivity of (18)F-PET as a diagnostic tool for identifying CKD patients with ABD.

View Article: PubMed Central - PubMed

Affiliation: Osteoporosis Unit, Division of Imaging Sciences and Biomedical Engineering, King's College London, Guy's Hospital Campus, Great Maze Pond, London, SE1 9RT, UK, michelle.frost@kcl.ac.uk.

ABSTRACT
(18)F-fluoride positron emission tomography ((18)F-PET) allows the assessment of regional bone formation and could have a role in the diagnosis of adynamic bone disease (ABD) in patients with chronic kidney disease (CKD). The purpose of this study was to examine bone formation at multiple sites of the skeleton in hemodialysis patients (CKD5D) and assess the correlation with bone biopsy. Seven CKD5D patients with suspected ABD and 12 osteoporotic postmenopausal women underwent an (18)F-PET scan, and bone plasma clearance, K i, was measured at ten skeletal regions of interest (ROI). Fifteen subjects had a transiliac bone biopsy following double tetracycline labeling. Two CKD5D patients had ABD confirmed by biopsy. There was significant heterogeneity in K i between skeletal sites, ranging from 0.008 at the forearm to 0.028 mL/min/mL at the spine in the CKD5D group. There were no significant differences in K i between the two study groups or between the two subjects with ABD and the other CKD5D subjects at any skeletal ROI. Five biopsies from the CKD5D patients had single tetracycline labels only, including the two with ABD. Using an imputed value of 0.3 Ī¼m/day for mineral apposition rate (MAR) for biopsies with single labels, no significant correlations were observed between lumbar spine K i corrected for BMAD (K i/BMAD) and bone formation rate (BFR/BS), or MAR. When biopsies with single labels were excluded, a significant correlation was observed between K i/BMAD and MAR (r = 0.81, p = 0.008) but not BFR/BS. Further studies are required to establish the sensitivity of (18)F-PET as a diagnostic tool for identifying CKD patients with ABD.

Show MeSH
Related in: MedlinePlus