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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 μm/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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Scatter plots showing the relationship between Ki/BMAD and mineral acquisition apposition rate using a model 1, including biopsies with single and double tetracycline labels, and b model 2, excluding biopsies with single or no tetracycline labels
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Fig3: Scatter plots showing the relationship between Ki/BMAD and mineral acquisition apposition rate using a model 1, including biopsies with single and double tetracycline labels, and b model 2, excluding biopsies with single or no tetracycline labels

Mentions: 18F-PET measurements of Ki, measured at the lumbar spine and corrected for BMAD, were directly compared to the four bone histomorphometric parameters, and the results are shown in Table 4, using a default value of 0.3 μm/day for MAR for biopsies with single labels only (model 1) and excluding biopsies with single labels (model 2), described in full in “Methods” section. Using model 1, there were no significant correlations between Ki/BMAD and any of the four bone histomorphometric parameters. For model 2, a significant correlation between Ki/BMAD and MAR was observed (r = 0.81, p = 0.008) but not between Ki/BMAD and BFR/BS (r = 0.59, p = 0.092) (Table 4). Figure 3 shows the scatter plots of Ki/BMAD against MAR. Two of the seven CKD patients had high values for Ki/BMAD but a low value for MAR of 0.30 μm/day as only a single tetracycline label was present, i.e., model 1 (Fig. 3a). These two outliers have an adverse impact on the correlation between Ki/BMAD and MAR as shown by the high correlation (r = 0.81, p = 0.008) between these two parameters when subjects with single labels (including the two outliers) are excluded using model 2 (Fig. 3b). There were no significant correlations between Ki, uncorrected for BMAD, at any skeletal site and either BFR or MAR.Table 4


(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)

Scatter plots showing the relationship between Ki/BMAD and mineral acquisition apposition rate using a model 1, including biopsies with single and double tetracycline labels, and b model 2, excluding biopsies with single or no tetracycline labels
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Scatter plots showing the relationship between Ki/BMAD and mineral acquisition apposition rate using a model 1, including biopsies with single and double tetracycline labels, and b model 2, excluding biopsies with single or no tetracycline labels
Mentions: 18F-PET measurements of Ki, measured at the lumbar spine and corrected for BMAD, were directly compared to the four bone histomorphometric parameters, and the results are shown in Table 4, using a default value of 0.3 μm/day for MAR for biopsies with single labels only (model 1) and excluding biopsies with single labels (model 2), described in full in “Methods” section. Using model 1, there were no significant correlations between Ki/BMAD and any of the four bone histomorphometric parameters. For model 2, a significant correlation between Ki/BMAD and MAR was observed (r = 0.81, p = 0.008) but not between Ki/BMAD and BFR/BS (r = 0.59, p = 0.092) (Table 4). Figure 3 shows the scatter plots of Ki/BMAD against MAR. Two of the seven CKD patients had high values for Ki/BMAD but a low value for MAR of 0.30 μm/day as only a single tetracycline label was present, i.e., model 1 (Fig. 3a). These two outliers have an adverse impact on the correlation between Ki/BMAD and MAR as shown by the high correlation (r = 0.81, p = 0.008) between these two parameters when subjects with single labels (including the two outliers) are excluded using model 2 (Fig. 3b). There were no significant correlations between Ki, uncorrected for BMAD, at any skeletal site and either BFR or MAR.Table 4

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 μm/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