Bone metabolic activity measured with positron emission tomography and [18F]fluoride ion in renal osteodystrophy: correlation with bone histomorphometry.
We evaluated the bone metabolic activity in patients with renal osteodystrophy using positron emission tomography and [18F]fluoride ion. Eight patients had secondary hyperparathyroidism (HPT), and three had low-turnover bone disease. Eleven normal subjects were also studied, and three of the eight HPT patients were reevaluated after therapy. A rate constant (K) describing the net transport of [18F] fluoride ion into a bound compartment in bone was calculated using both a three-compartment model and Patlak graphical analysis. Values of K were compared with biochemical data and with histomorphometric indices. The results indicate that K is significantly higher (P < 0.01) in HPT patients than in normal subjects and patients with low-turnover bone disease. Values of K correlated with serum alkaline phosphatase (r = 0.81) and PTH (r = 0.93) levels and with histomorphometric indices of bone formation rate (r = 0.84, P < 0.01) and eroded perimeter (r = 0.77, P < 0.05). Values of K decreased by 40 and 30%, respectively, in two patients who underwent parathyroidectomy and medical therapy. Positron emission tomography studies of bone using [18F]fluoride ion can differentiate low turnover from high turnover lesions of renal osteodystrophy and provide quantitative estimates of bone cell activity that correlate with histomorphometric data.
Messa
C
C
Division of Nuclear Medicine and Biophysics, UCLA School of Medicine 90024-1721.
Goodman
W G
WG
Hoh
C K
CK
Choi
Y
Y
Nissenson
A R
AR
Salusky
I B
IB
Phelps
M E
ME
Hawkins
R A
RA
D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood / Q000378:metabolism; D001862:Bone Resorption; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D002117:Calcitriol / Q000627:therapeutic use; D002118:Calcium / Q000097:blood / Q000378:metabolism; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010280:Parathyroid Glands / Q000473:pathology / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood / Q000378:metabolism; D010758:Phosphorus / Q000097:blood / Q000378:metabolism; D012044:Regression Analysis; D014055:Tomography, Emission-Computed
D005462:Fluorine Radioisotopes; D010281:Parathyroid Hormone; D010758:Phosphorus; D000469:Alkaline Phosphatase; D002117:Calcitriol; D002118:Calcium