Abstract
Purpose
We evaluate a new quantitative method of acquiring and analysing 18F positron emission tomography (PET) studies that enables regional bone plasma clearance (K i ) to be estimated from static scans acquired at multiple sites in the skeleton following a single injection of tracer.
Methods
Dynamic lumbar spine 18F PET data from two clinical trials were used to simulate a series of static scans acquired 30–60 min after injection. Venous blood samples were taken at 30, 40, 50 and 60 min and K i evaluated by Patlak analysis and the static scan method. The data were used to evaluate the precision errors of the Patlak and static scan methods expressed as the percentage coefficient of variation (%CV) and compare their response to 6 months of treatment with the bone anabolic agent teriparatide.
Results
Static scan K i measurements 30–60 min after injection were highly correlated with the Patlak results (r > 0.99). The %CV for the static scan method was 17.5% 30 min after injection, decreasing to 14.5% at 60 min, compared with 13.0% for Patlak analysis. Response to teriparatide treatment was +25.2% for the static scan method compared with +24.3% for Patlak analysis. The mean ratio (SD) of the static scan and Patlak K i results was 1.006 (0.015) at 30 min after injection decreasing to 0.965 (0.015) at 60 min.
Conclusion
18F-Fluoride bone plasma clearance can be estimated from a static scan and venous blood samples acquired 30–60 min after injection. The method enables K i to be estimated at multiple skeletal sites with a single injection of tracer.
Similar content being viewed by others
References
Hawkins RA, Choi Y, Huang S-C, Hoh CK, Dahlborn M, Schiepers C, et al. Evaluation of the skeletal kinetics of fluorine-18-fluoride ion with PET. J Nucl Med 1992;33:633–42.
Schiepers C, Nuyts J, Bormans G, Dequeker J, Bouillon R, Mortelmans L, et al. Fluoride kinetics of the axial skeleton measured in vivo with fluorine-18-fluoride PET. J Nucl Med 1997;38:1970–6.
Cook GJR, Blake GM, Marsden PK, Cronin B, Fogelman I. Quantification of skeletal kinetic indices in Paget’s disease using dynamic 18F-fluoride positron emission tomography. J Bone Miner Res 2002;17:854–9.
Frost ML, Cook GJR, Blake GM, Marsden PK, Benatar NA, Fogelman I. A prospective study of risedronate on regional bone metabolism and blood flow at the lumbar spine measured by 18F-fluoride positron emission tomography. J Bone Miner Res 2003;18:2215–22.
Installé J, Nzeusseu A, Bol A, Depresseux G, Devogelaer JP, Lonneux M. (18)F-fluoride PET for monitoring therapeutic response in Paget’s disease of bone. J Nucl Med 2005;46:1650–8.
Uchida K, Nakajima H, Miyazaki T, Yayama T, Kawahara H, Kobayashi S, et al. Effects of alendronate on bone metabolism in glucocorticoid-induced osteoporosis measured by 18F-fluoride PET: a prospective study. J Nucl Med 2009;50:1808–14.
Frost ML, Siddique M, Blake GM, Moore AE, Schleyer PJ, Dunn JT, et al. Differential effects of teriparatide on regional bone formation using (18)F-fluoride positron emission tomography. J Bone Miner Res 2011;26:1002–11.
Patlak CS, Blasberg RG, Fenstermacher JD. Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. J Cereb Blood Flow Metab 1983;3:1–7.
Brenner W, Vernon C, Muzi M, Mankoff DA, Link JM, Conrad EU, et al. Comparison of different quantitative approaches to 18F-fluoride PET scans. J Nucl Med 2004;45:1493–500.
Siddique M, Frost ML, Blake GM, et al. The precision and sensitivity of 18F-fluoride PET for measuring regional bone metabolism: a comparison of quantification methods. J Nucl Med 2011. doi:10.2967/jnumed.111.093195
Cheebsumon P, Velasquez LM, Hoekstra CJ, Hayes W, Kloet RW, Hoetjes NJ, et al. Measuring response to therapy using FDG PET: semi-quantitative and full kinetic analysis. Eur J Nucl Med Mol Imaging 2011;38:832–42.
Blake GM, Siddique M, Frost ML, Moore AEB, Fogelman I. Radionuclide studies of bone metabolism: do bone uptake and bone plasma clearance provide equivalent measurements of bone turnover? Bone 2011;49:537–42.
Blake GM, Frost ML, Fogelman I. Quantitative radionuclide studies of bone. J Nucl Med 2009;50:1747–50.
Cook GJ, Lodge MA, Marsden PK, Dynes A, Fogelman I. Non-invasive assessment of skeletal kinetics using fluorine-18 fluoride positron emission tomography: evaluation of image and population-derived arterial input functions. Eur J Nucl Med 1999;26:1424–9.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1(8476):307–10.
Glüer C-C, Blake G, Lu Y, Blunt BA, Jergas M, Genant HK. Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int 1995;5:262–70.
Lockhart CM, MacDonald LR, Alessio AM, McDougald WA, Doot RK, Kinahan PE. Quantifying and reducing the effect of calibration error on variability of PET/CT standardized uptake value measurements. J Nucl Med 2011;52:218–24.
Ishizu K, Nishizawa S, Yonekura Y, Sadato N, Magata Y, Tamaki N, et al. Effects of hyperglycemia on FDG uptake in human brain and glioma. J Nucl Med 1994;35:1104–9.
Thie JA. Clarification of a fractional uptake concept. J Nucl Med 1995;36:711–2.
Ishizu K, Yonekura Y. Clarification of a fractional uptake concept—reply. J Nucl Med 1995;36:712.
Puri T, Blake GM, Frost ML, Moore AE, Siddique M, Cook GJ, et al. Validation of image-derived arterial input functions at the femoral artery using 18F-fluoride positron emission tomography. Nucl Med Commun 2011;32:808–17.
Blake GM, Park-Holohan S, Cook GJR, Fogelman I. Quantitative studies of bone with the use of 18F-fluoride and 99mTc-methylene diphosphonate. Semin Nucl Med 2001;31:28–49.
Acknowledgement
Study 1 was supported by an unrestricted grant from Warner Chilcott. Study 2 was supported by a research grant from Eli Lilly & Company.
Author information
Authors and Affiliations
Corresponding author
Appendix: sensitivity analysis
Appendix: sensitivity analysis
Differentiating K i with respect to V 0 , in Eq. 2, we get,
Typically at T = 60 min, \( {C_{{plasma}}}(T) = {\text{ 2 KBq}}/{\text{ml}} \), and \( \int_0^T {{C_{{plasma}}}(t)dt} = {26}0\,{\text{KBq}}/{\text{ml}} {\text{min,}} \)so, \( \frac{{d{K_i}}}{{d{V_0}}} = { } - 0.0{77} \)
Assuming V 0 takes values 0.4 ± 0.2, maximum error in net plasma clearance is:
Since the typical K i value at the lumbar spine is 0.03, the percentage error is:
Rights and permissions
About this article
Cite this article
Siddique, M., Blake, G.M., Frost, M.L. et al. Estimation of regional bone metabolism from whole-body 18F-fluoride PET static images. Eur J Nucl Med Mol Imaging 39, 337–343 (2012). https://doi.org/10.1007/s00259-011-1966-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00259-011-1966-y