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Assessment of bone synthetic activity in inflammatory lesions and syndesmophytes in patients with ankylosing spondylitis: the potential role of 18F-fluoride positron emission tomography-magnetic resonance imaging
S.-G. Lee1, I.-J. Kim2, K.-Y. Kim3, H.-Y. Kim4, K.-J. Park5, S.-J. Kim6, E.-K. Park7, Y.-K. Jeon8, B.-Y. Yang9, G.-T. Kim10
- Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
- Department of Internal Medicine, and Department of Nuclear Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
- Department of Nuclear Medicine, Kosin University College of Medicine, Busan, South Korea.
- Department of Nuclear Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
- Department of Nuclear Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
- Department of Nuclear Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
- Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
- Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
- Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
- Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
CER7716
2015 Vol.33, N°1
PI 0090, PF 0097
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PMID: 25572626 [PubMed]
Received: 03/07/2014
Accepted : 17/09/2014
In Press: 09/01/2015
Published: 04/03/2015
Abstract
OBJECTIVES:
18F-fluoride uptake represents active osteoblastic bone synthesis. We assessed bone synthetic activity in inflammatory lesions and syndesmophytes in patients with ankylosing spondylitis (AS) using 18F-fluoride positron emission tomography-magnetic resonance imaging (PET-MRI, Philips Healthcare, Cleveland, OH, USA) and x-ray.
METHODS:
All images of 12 AS patients were recorded with the presence or absence of increased 18F-fluoride uptake lesions on PET, acute (type A) or advanced (type B) corner inflammatory lesions (CILs) on MRI, syndesmophytes on x-ray at the anterior vertebral corners. An increased 18F-fluoride uptake lesion was defined as an uptake which is greater than the uptake in the adjacent normal vertebral body. The association of a CIL or syndesmophyte with an increased 18F-fluoride uptake lesion was investigated by generalised linear latent mixed models analysis to adjust within-patient dependence for total numbers of vertebral corners.
RESULTS:
There were 67 type A CILs (12.1%), 37 type B CILs (6.7%) and 58 increased 18F-fluoride uptake lesion (10.4%) out of 552 vertebral corners and there were 57 syndesmophytes (19.8%) out of 288 vertebral corners. A type A CIL (OR=3.2, 95% CI=1.6-6.5, p=0.001), type B CIL (OR=59.9, 95% CI=23.5-151.5, p<0.001) and syndesmpophyte (OR=21.8, 95% CI=5.5-85.2, p<0.001) were significantly associated with an increased 18F-fluoride uptake lesion.
CONCLUSIONS:
Our data suggest that an inflammatory lesion as well as a syndesmophyte is associated with active bone synthesis assessed by 18F-fluoride uptake in the spine of AS patients. 18F-fluoride PET-MRI may have the potential for investigating the pathogenesis of structural damage in AS.
