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Assessment of regional and total skeletal metabolism using 18F-NaF PET/CT in patients with chronic kidney disease

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Abstract

Objective

The study aims to assess regional and total bone metabolic activity in patients with chronic kidney disease using Na[18F]F PET and correlation between semi-quantitative indices and blood parameters.

Methods

Seventy-two subjects (mean age 61.8 ± 13.8 years) were included. Of these 24/72 patients had end-stage renal disease (ESRD) (GFR < 15 mL/min/1.73 m2), 38/72 had chronic kidney disease (CKD) (GFR between 60 and 15 mL/min/1.73 m2), and 10/72 were controls with normal renal function. All subjects underwent Na[18F]F PET-CT with a dose activity of 0.06 mCi/Kg. Regional and total skeletal metabolism were assessed with mean SUVs in a skeletal volume of interest (VOI), bone to soft tissue index (B/S), global SUV mean (GSUV mean) of the whole bone, and uptake in the femoral neck.

Results

Statistically significant differences were observed in a number of 18F-NaF metrics like femoral neck metabolism in CKD and ERSD groups in comparison to control in right (P = 0.003) and left femur (P = 0.006), bone to soft tissue index in the femur (P = 0.016) and GSUV5 (P = 0.006). There is also a significant difference in SUV mean in lumbar vertebrae (L1–L4) among CKD, ESRD, and controls. There was a moderate correlation between 18F-NaF PET scan uptake and blood parameters such as ALP and PTH. Na[18F]F uptake parameters were significantly different in low versus high bone turnover state.

Conclusions

The assessment of total skeleton and regional metabolism and bone turnover in CKD patients is feasible with Na[18F]F PET. Na[18F]F can help to detect early changes in bone metabolism and assess the progression of bone disease in this complex condition. Quantification with Na[18F]F PET might provide better assessment of the bone turnover. The difference in Na[18F]F uptake in CKD compared to controls is likely related to a change in bone turnover which, however, requires further validation.

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Data availability

The data of this study can be available on request from the corresponding author.

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Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman

    Sharjeel Usmani

  2. Department of Nuclear Medicine, Jaber Al-Ahmad Molecular Imaging Center, Kuwait, Kuwait

    Fahad Marafi

  3. Department of Nuclear Medicine, Jack Brignall PET/CT Centre, Castle Hill Hospital, Cottingham, UK

    Najeeb Ahmed

  4. Hull York Medical School, Hull, UK

    Sharjeel Usmani & Najeeb Ahmed

  5. Department of Nuclear Medicine, Royal Free Hospital NHS Trust, London, UK

    Gopinath Gnanasegaran

  6. Australian College of Kuwait, Kuwait, Kuwait

    Ahmed Bani-Mustafa

  7. Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium

    Tim Van den Wyngaert

  8. Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Sharjeel Usmani & Tim Van den Wyngaert

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  1. Sharjeel Usmani
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Correspondence to Sharjeel Usmani.

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All procedure performed in studies involving human participants were in accordance with the ethical standard of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Usmani, S., Ahmed, N., Gnanasegaran, G. et al. Assessment of regional and total skeletal metabolism using 18F-NaF PET/CT in patients with chronic kidney disease. Ann Nucl Med (2024). https://doi.org/10.1007/s12149-024-01929-1

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