Can Na18F PET/CT be used to study bone remodeling in the tibia when patients are being treated with a Taylor Spatial Frame?
Monitoring and quantifying bone remodeling are of interest, for example, in correction osteotomies, delayed fracture healing pseudarthrosis, bone lengthening, and other instances. Seven patients who had operations to attach an Ilizarov-derived Taylor Spatial Frame to the tibia gave informed consent. Each patient was examined by Na(18)F PET/CT twice, at approximately six weeks and three months after the operation. A validated software tool was used for the following processing steps. The first and second CT volumes were aligned in 3D and the respective PET volumes were aligned accordingly. In the first PET volume spherical volumes of interest (VOIs) were delineated for the crural fracture and normal bone and transferred to the second PET volume for SUVmax evaluation. This method potentially provides clinical insight into questions such as, when has the bone remodeling progressed well enough to safely remove the TSF? and when is intervention required, in a timelier manner than current methods? For example, in two patients who completed treatment, the SUVmax between the first and second PET/CT examination decreased by 42% and 13%, respectively. Further studies in a larger patient population are needed to verify these preliminary results by correlating regional Na(18)F PET measurements to clinical and radiological findings.
Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institute, A2:07, 171 76 Stockholm, Sweden.
Henrik
H
Lundblad
School of Information and Communication Technology, KTH Royal Institute of Technology, Isafjordsgatan 26, 418 164-40 Stockholm, Sweden.
Gerald Q
GQ
Maguire
Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institute, A2:07, 171 76 Stockholm, Sweden.
Henrik
H
Olivecrona
Department of Hospital Physics, Karolinska University Hospital, 17 176 Solna, Stockholm, Sweden.
Cathrine
C
Jonsson
Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institute, A2:07, 171 76 Stockholm, Sweden.
Hans
H
Jacobsson
Department of Radiology, New York University, 550 First Avenue, THW232, New York, NY 10016, USA.
Marilyn E
ME
Noz
School of Computing, College of Engineering, University of Utah, 50 Central Campus Dr., Room 3190, Salt Lake City, UT 84112, USA.
Michael P
MP
Zeleznik
Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institute, A2:07, 171 76 Stockholm, Sweden.
Lars
L
Weidenhielm
Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institute, A2:07, 171 76 Stockholm, Sweden.
Anders
A
Sundin
D000293:Adolescent; D000328:Adult; D016723:Bone Remodeling; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013977:Tibia / Q000000981:diagnostic imaging* / Q000293:injuries; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D019275:Radiopharmaceuticals