A novel approach for fibrous dysplasia assessment using combined planar and quantitative SPECT/CT analysis of Tc-99m-diphosphonate bone scan in correlation with biological bone turnover markers of disease activity.
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License: CC BY 4.0
Serval ID
serval:BIB_0499045C2F0C
Type
Article: article from journal or magazin.
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Publications
Institution
Title
A novel approach for fibrous dysplasia assessment using combined planar and quantitative SPECT/CT analysis of Tc-99m-diphosphonate bone scan in correlation with biological bone turnover markers of disease activity.
Journal
Frontiers in medicine
ISSN
2296-858X (Print)
ISSN-L
2296-858X
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
9
Pages
1050854
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
To investigate the emerging role of Tc-99m-labeled diphosphonate (Tc-99m-DPD) uptake quantification by SPECT/CT in fibrous dysplasia (FD) bone lesions and its correlation with biological bone turnover markers (BTMs) of disease activity.
Seven patients (49 ± 16 years) with a confirmed diagnosis of FD were included in this retrospective study. Bone scans with Tc-99m-DPD and quantitative SPECT/CT (xSPECT/CT) were performed. SUV <sub>max</sub> (maximum standard unit value) and SUV <sub>mean</sub> (mean standard unit value) were measured in all FD bone lesions. The skeletal burden score (SBS) was assessed on planar scintigraphy and multiplied by mean SUV <sub>max</sub> and SUV <sub>mean</sub> to generate two new parameters, SBS_SUV <sub>max</sub> and SBS_SUV <sub>mean</sub> , respectively. Planar and xSPECT/CT quantitative measures were correlated with biological BTMs of disease activity, including fibroblast growth factor 23 (FGF-23), alkaline phosphatase (ALP), procollagen 1 intact N-terminal propeptide (P1NP) and C-terminal telopeptide (CTX), as well as scoliosis angle measured on radiographs. Statistical significance was evaluated with Spearman's correlations.
A total of 76 FD bone lesions were analyzed, showing an average SUV <sub>max</sub> and SUV <sub>mean</sub> (g/mL) of 13 ± 7.3 and 8 ± 4.5, respectively. SBS, SBS_SUV <sub>max</sub> and SBS_SUV <sub>mean</sub> values were 30.8 ± 25.6, 358 ± 267 and 220.1 ± 164.5, respectively. Mean measured values of FGF-23 (pg/mL), ALP (U/L), P1NP (μg/L) and CTX (pg/mL) were 98.4 (22-175), 283.5 (46-735), 283.1 (31-1,161) and 494 (360-609), respectively. Mean scoliosis angle was 15.7 (7-22) degrees. We found a very strong positive correlation between planar-derived SBS and CTX (r = 0.96, p = 0.010), but no significant correlation between SUV <sub>max</sub> or SUV <sub>mean</sub> and biological BTMs. SBS_SUV <sub>max</sub> showed a strong to very strong positive correlation with CTX (ρ = 0.99, p = 0.002), FGF-23 (ρ = 0.91, p = 0.010), ALP (ρ = 0.82, p = 0.020), and P1NP (ρ = 0.78, p = 0.039), respectively.
This study showed that biological BTMs are significantly correlated with diphosphonate uptake on bone scan, quantified by a new parameter combining information from both planar and quantitative SPECT/CT. Further analysis of bone scan quantitative SPECT/CT data in a larger patient population might help better characterize the skeletal disease burden in FD, and guide treatment and follow-up.
Seven patients (49 ± 16 years) with a confirmed diagnosis of FD were included in this retrospective study. Bone scans with Tc-99m-DPD and quantitative SPECT/CT (xSPECT/CT) were performed. SUV <sub>max</sub> (maximum standard unit value) and SUV <sub>mean</sub> (mean standard unit value) were measured in all FD bone lesions. The skeletal burden score (SBS) was assessed on planar scintigraphy and multiplied by mean SUV <sub>max</sub> and SUV <sub>mean</sub> to generate two new parameters, SBS_SUV <sub>max</sub> and SBS_SUV <sub>mean</sub> , respectively. Planar and xSPECT/CT quantitative measures were correlated with biological BTMs of disease activity, including fibroblast growth factor 23 (FGF-23), alkaline phosphatase (ALP), procollagen 1 intact N-terminal propeptide (P1NP) and C-terminal telopeptide (CTX), as well as scoliosis angle measured on radiographs. Statistical significance was evaluated with Spearman's correlations.
A total of 76 FD bone lesions were analyzed, showing an average SUV <sub>max</sub> and SUV <sub>mean</sub> (g/mL) of 13 ± 7.3 and 8 ± 4.5, respectively. SBS, SBS_SUV <sub>max</sub> and SBS_SUV <sub>mean</sub> values were 30.8 ± 25.6, 358 ± 267 and 220.1 ± 164.5, respectively. Mean measured values of FGF-23 (pg/mL), ALP (U/L), P1NP (μg/L) and CTX (pg/mL) were 98.4 (22-175), 283.5 (46-735), 283.1 (31-1,161) and 494 (360-609), respectively. Mean scoliosis angle was 15.7 (7-22) degrees. We found a very strong positive correlation between planar-derived SBS and CTX (r = 0.96, p = 0.010), but no significant correlation between SUV <sub>max</sub> or SUV <sub>mean</sub> and biological BTMs. SBS_SUV <sub>max</sub> showed a strong to very strong positive correlation with CTX (ρ = 0.99, p = 0.002), FGF-23 (ρ = 0.91, p = 0.010), ALP (ρ = 0.82, p = 0.020), and P1NP (ρ = 0.78, p = 0.039), respectively.
This study showed that biological BTMs are significantly correlated with diphosphonate uptake on bone scan, quantified by a new parameter combining information from both planar and quantitative SPECT/CT. Further analysis of bone scan quantitative SPECT/CT data in a larger patient population might help better characterize the skeletal disease burden in FD, and guide treatment and follow-up.
Keywords
SPECT/CT, bone scan, bone turnover markers, fibrous dysplasia, quantitative imaging, scintigraphy
Pubmed
Web of science
Open Access
Yes
Create date
19/12/2022 10:20
Last modification date
10/10/2023 6:00
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