Issn Print: 0143-3636
Publication Date: 2001/04/01
45. Quantification of skeletal kinetic indices in Paget's disease using dynamic 18F-fluoride PET
G. J.R. Cook; G. M. Blake; P. K. Marsden; B. Cronin; I. Fogelman
Excerpt
The purpose of this study was to quantify indices of regional bone metabolism in Paget's disease and to compare with normal bone using dynamic 18F-fluoride positron emission tomography (PET). Seven patients with vertebral Paget's disease had one-hour dynamic 18F-deoxyglucose PET scans performed to include a diseased and an adjacent normal vertebra. Arterial plasma input functions were also measured. A three-compartment four-parameter model was used with non-linear regression analysis to estimate parameters. Compared with normal bone, pagetic vertebrae demonstrated higher values of plasma clearance to bone mineral (Ki) and clearance to total bone tissue (K1), reflecting increased mineralization and blood flow. Release of 18F from bone mineral (k4) was lower in pagetic vertebrae, suggesting tighter binding of 18F to bone mineral. The notional volume of the extravascular compartment (K1/k2) was greater in pagetic bone. Although the unidirectional extraction efficiency from the extravascular space to bone mineral (Ki/K1) was greater in pagetic vertebrae, a lower pagetic value of k2, describing the rate of transfer from the central extravascular compartment to plasma, suggests that the 18F that enters the relatively fibrotic marrow space of pagetic bone may be less accessible for return to plasma. These findings confirm some of the known pathophysiology of Paget's disease, introduce some new observations and demonstrate how dynamic 18F PET may be of value in the measurement of regional metabolic parameters in focal bone disorders.
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