scholarly journals Bone Histomorphometry and 18F-Sodium Fluoride Positron Emission Tomography Imaging: Comparison Between only Bone Turnover-based and Unified TMV-based Classification of Renal Osteodystrophy

2021 ◽  
Author(s):  
Louise Aaltonen ◽  
Niina Koivuviita ◽  
Marko Seppänen ◽  
Inari S. Burton ◽  
Heikki Kröger ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Bone Turnover ◽  
Bone Disease ◽  
Bone Biopsy ◽  
Emission Tomography ◽  
Adynamic Bone Disease ◽  
High Turnover ◽  
Positron Emission ◽  
Adynamic Bone

AbstractBone biopsy is the gold standard for characterization of renal osteodystrophy (ROD). However, the classification of the subtypes of ROD based on histomorphometric parameters is not unambiguous and the range of normal values for turnover differ in different publications. 18F-Sodium Fluoride positron emission tomography (18F-NaF PET) is a dynamic imaging technique that measures turnover. 18F-NaF PET has previously been shown to correlate with histomorphometric parameters. In this cross-sectional study, 26 patients on dialysis underwent a 18F-NaF PET and a bone biopsy. Bone turnover-based classification was assessed using Malluche’s historical reference values for normal bone turnover. In unified turnover-mineralization-volume (TMV)-based classification, the whole histopathological picture was evaluated and the range for normal turnover was set accordingly. Fluoride activity was measured in the lumbar spine (L1–L4) and at the anterior iliac crest. On the basis of turnover-based classification of ROD, 12% had high turnover and 61% had low turnover bone disease. On the basis of unified TMV-based classification of ROD, 42% had high turnover/hyperparathyroid bone disease and 23% had low turnover/adynamic bone disease. When using unified TMV-based classification of ROD, 18F-NaF PET had an AUC of 0.86 to discriminate hyperparathyroid bone disease from other types of ROD and an AUC of 0.87, for discriminating adynamic bone disease. There was a disproportion between turnover-based classification and unified TMV-based classification. More research is needed to establish normal range of bone turnover in patients with CKD and to establish the role of PET imaging in ROD.

scholarly journals SO07118F-SODIUM FLUORIDE POSITRON EMISSION TOMOGRAPHY AND BONE HISTOMORPHOMETRY - COMPARISON BETWEEN ONLY BONE TURNOVER -BASED AND EXPERT EVALUATION -BASED CLASSIFICATION OF RENAL OSTEODYSTROPHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Louise Caroline Aaltonen ◽  
Niina Koivuviita ◽  
Marko Seppänen ◽  
Inari Burton ◽  
Heikki Kröger ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Renal Osteodystrophy ◽  
Bone Disease ◽  
Bone Biopsy ◽  
Formation Rate ◽  
Adynamic Bone Disease ◽  
High Turnover ◽  
Bone Formation Rate ◽  
Adynamic Bone

Abstract Background and Aims The diagnosis and the differentiation of renal osteodystrophy (ROD) are challenging. Bone biopsy is the golden standard, but it is invasive and not available in every center. Bone turnover rate is defined by bone formation rate and/or activation frequency. Adynamic bone disease is defined as low turnover bone with reduced osteoblast- and osteoclast activities. Hyperparahyreoid bone disease or osteitis fibrosa is defined as high turnover bone with osteoclast- and osteoblast activities and fibrosis. 18F- Sodium Fluoride positron emission tomography (18F-NaF PET) is a noninvasive imaging technique that allows assessment of regional bone turnover. The aim was to assess how well bone turnover –based classification of ROD correlates with the classification determined by an expert histomorphometrist (HK), and how these correlate with 18F-NaF PET analysis Method A total of 24 dialysis patients underwent a 18F-NaF PET scan. Fluoride activity was measured at the anterior iliac crest and in the lumbar region. An iliac crest bone biopsy was obtained within 4 weeks from the PET-scan. The diagnosis of bone histomorphometry was determined based on turnover-mineralization-volume (TMV) classification. Firstly, bone turnover was assessed using bone formation rate and activation frequency. Secondly, also other histomorphometric parameters (eg. osteoid volume, osteoid surface, resorption surface, mineralized surface, osteoblast and osteoclast surfaces and peritrabecular fibrosis) were also taking into account for classification of ROD by a histomorphometrist. Results Based on bone turnover parameters only, 12% of the patients had high turnover and 64% low turnover. When the diagnosis of renal osteodystrophy was made by a histomorphometrist, 40% had hyperparathyreoid bone/osteitis fibrosa and 24% adynamic bone disease or ostemalasia. 18F-NaF PET´s sensitivity to recognize hyperparathyreoid bone disease was 80% end specificity 100% (cut-of value 0.055).18F-NaF PET´s sensitivity to recognize adynamic bone disease was 100% and specificity 61% (cut-of value of fluoride-activity 0.038) Conclusion 18F-NaF PET works well as a diagnostic tool, when the diagnosis of ROD is based on the histopathological evaluation. It remains unknown how variations in normal bone turnover rate can be detected in CKD patients by 18F-NaF PET and if treatment decisions of ROD can be made only based on bone turnover.

scholarly journals 18F-fluoride Positron Emission Tomography Measurements of Regional Bone Formation in Hemodialysis Patients with Suspected Adynamic Bone Disease

2013 ◽  
Vol 93 (5) ◽  
pp. 436-447 ◽  
Author(s):  
Michelle L. Frost ◽  
Juliet E. Compston ◽  
David Goldsmith ◽  
Amelia E. Moore ◽  
Glen M. Blake ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Bone Formation ◽  
Bone Disease ◽  
Hemodialysis Patients ◽  
Emission Tomography ◽  
Adynamic Bone Disease ◽  
Positron Emission ◽  
Adynamic Bone ◽  
18F Fluoride

The physical basis of application of positron emission tomography and modern radiopharms

2021 ◽  
Vol 4 ◽  
Author(s):  
L.I. , Galchenko ◽  
◽  
A.N. Kalyagin
Keyword(s):  
Positron Emission Tomography ◽  
Time Distribution ◽  
Space Time ◽  
Physical Basis ◽  
Emission Tomography ◽  
Annihilation Radiation ◽  
Review Of The Literature ◽  
Diagnostic Practice ◽  
Positron Emission

This article provides a review of the literature on the history, physical and technical foundations and features of the application of positron emission tomography (PET), which came into practice in the 1970s. PET is a method of visualizing the space-time distribution of a positron-emitting radiopharmaceutical (RP) in the patient‘s body by annihilation radiation. The classification of radiopharmaceuticals that are used in clinical and diagnostic practice is considered.

Destination of Mental Disorders Through Biochemical and Neuropathological Analysis?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P. Falkai
Keyword(s):  
Positron Emission Tomography ◽  
Mental Disorders ◽  
Psychiatric Disorders ◽  
Clinical Symptoms ◽  
Emission Tomography ◽  
Imaging Findings ◽  
Severe Mental Disorders ◽  
Positron Emission ◽  
Dopamine Hypothesis

In the first half of the last century researchers believed that severe mental disorders like schizophrenia have a neuropathological basis. Up to now it has been difficult to prove any consistent core finding for this disorder. Reason for this might be that it is a network disorder and therefore regional specific findings will unlikely be found. Parallel to that describing the dopamine hypothesis of schizophrenia and the catechol amine deficit hypothesis of depression were very helpful for understanding the mechanisms of antipsychotics and antidepressants working in these disorders. Especially the introduction of the positron emission tomography has helped to link symptoms with the transmitter systems. However, none of these findings are specific for schizophrenia or depression. During the talk it will be discussed when the combination of core clinical symptoms, imaging findings and genetic variables are helpful for a future classification of psychiatric disorders.

scholarly journals Positron Emission Tomography (PET) Radiopharmaceuticals in Multiple Myeloma

Molecules ◽  
2019 ◽  
Vol 25 (1) ◽  
pp. 134 ◽  
Author(s):  
Christos Sachpekidis ◽  
Hartmut Goldschmidt ◽  
Antonia Dimitrakopoulou-Strauss
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Disease ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg

Multiple myeloma (MM) is a plasma cell disorder, characterized by clonal proliferation of malignant plasma cells in the bone marrow. Bone disease is the most frequent feature and an end-organ defining indicator of MM. In this context, imaging plays a pivotal role in the management of the malignancy. For several decades whole-body X-ray survey (WBXR) has been applied for the diagnosis and staging of bone disease in MM. However, the serious drawbacks of WBXR have led to its gradual replacement from novel imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT). PET/CT, with the tracer 18F-fluorodeoxyglucose (18F-FDG), is now considered a powerful diagnostic tool for the detection of medullary and extramedullary disease at the time of diagnosis, a reliable predictor of survival as well as the most robust modality for treatment response evaluation in MM. On the other hand, 18F-FDG carries its own limitations as a radiopharmaceutical, including a rather poor sensitivity for the detection of diffuse bone marrow infiltration, a relatively low specificity, and the lack of widely applied, established criteria for image interpretation. This has led to the development of several alternative PET tracers, some of which with promising results regarding MM detection. The aim of this review article is to outline the major applications of PET/CT with different radiopharmaceuticals in the clinical practice of MM.

Early Detection and Accurate Description of Extent of Metastatic Bone Disease in Breast Cancer With Fluoride Ion and Positron Emission Tomography

1999 ◽  
Vol 17 (8) ◽  
pp. 2381-2381 ◽  
Author(s):  
Holger Schirrmeister ◽  
Albrecht Guhlmann ◽  
Jörg Kotzerke ◽  
Claudia Santjohanser ◽  
Thorsten Kühn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Positron Emission Tomography ◽  
Bone Marrow ◽  
Bone Metastases ◽  
Bone Disease ◽  
Roc Curve ◽  
Metastatic Bone Disease ◽  
Emission Tomography ◽  
Fluoride Ion ◽  
Positron Emission

PURPOSE: Previous studies have shown that bone metastases are revealed by magnetic resonance imaging (MRI) or bone marrow scintigraphy several months before they are visible by conventional bone scintigraphy (BS). We present a new approach for detecting bone metastases in patients with breast cancer. We compared findings obtained with fluoride ion (F-18) and positron emission tomography (PET) with those obtained with conventional BS. PATIENTS AND METHODS: Thirty-four breast cancer patients were prospectively examined using F-18–PET and conventional BS. F-18–PET and BS were performed within 3 weeks of each other. Metastatic bone disease was previously known to be present in six patients and was suspected (bone pain or increasing levels of tumor markers, Ca2+, alkaline phosphatase) in 28 patients. Both imaging modalities were compared by patient-by-patient analysis and lesion-by-lesion analysis, using a five-point scale for receiver operating characteristic (ROC) curve analysis. A panel of reference methodswas used, including MRI (28 patients), planar x-ray (17 patients), and spiral computed tomography (four patients). RESULTS: With F-18–PET, 64 bone metastases were detected in 17 patients. Only 29 metastases were detected in 11 patients with BS. As a result of F-18–PET imaging, clinical management was changed in four patients (11.7%). For F-18–PET, the area under the ROC curve was 0.99 on a lesion basis (for BS, it was 0.74; P < .05) and 1.00 on a patient basis (for BS, it was 0.82; P < .05). CONCLUSION: F-18–PET demonstrates a very early bone reaction when small bone marrow metastases are present, allowing accurate detection of breast cancer bone metastases. This accurate detection has a significant effect on clinical management, compared with the effect on management brought about by detection with conventional BS.

Imaging of Site Specific Bone Turnover in Osteoporosis Using Positron Emission Tomography

2014 ◽  
Vol 12 (4) ◽  
pp. 475-485 ◽  
Author(s):  
Glen M. Blake ◽  
Musib Siddique ◽  
Michelle L. Frost ◽  
Amelia E. B. Moore ◽  
Ignac Fogelman
Keyword(s):  
Positron Emission Tomography ◽  
Bone Turnover ◽  
Emission Tomography ◽  
Site Specific ◽  
Positron Emission
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