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18F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the performance of 18F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS).

Methods

Included in the study were 15 patients with AS according to the modified New York criteria (AS group) and with active disease and 13 patients with mechanical low back pain (MLBP; control group) who were investigated with whole-body 18F-fluoride PET/CT. The ratio of the uptake in the SIJ and that in the sacrum (SIJ/S) was calculated for every joint.

Results

The mean SIJ/S ratio of 30 quantified joints in the AS group was 1.66 (range 1.10–3.07) with PET/CT, and the mean SIJ/S ratio of 26 quantified joints in the MLBP group was 1.12 (range 0.71–1.52). The area under the receiver operating characteristic curve for SIJ arthritis was 0.84. With plain radiography as a the gold standard and taking an SIJ/S ratio of >1.3 as the threshold, the sensitivity, specificity and accuracy on a per patient basis were 80%, 77% and 79%, respectively. On a per SIJ basis, the greatest sensitivity (94%) was found in grade 3 sacroiliitis (n = 16).

Conclusion

Our results suggest that quantitative 18F-fluoride PET/CT may play a role in the diagnosis of sacroiliitis in active AS and is an alternative to conventional bone scintigraphy in times of molybdenum shortage.

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Acknowledgment

We thank our technicians, especially Sabine Knöfel, Thomas Berthold and Ennio Müller for scanning the patients.

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Authors and Affiliations

  1. Department of Medical Radiology, Division of Nuclear Medicine, University Hospital, Zurich, Switzerland

    Klaus Strobel, Dorothee R. Fischer, Katrin D. M. Stumpe & Gustav K. von Schulthess

  2. Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland

    Giorgio Tamborrini, Diego Kyburz, Beat A. Michel & Adrian Ciurea

  3. Radiopharmacy, University Hospital Zurich, Zurich, Switzerland

    Rolf G. X. Hesselmann & A. Johayem

  4. Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland

    Klaus Strobel

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  1. Klaus Strobel
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  2. Dorothee R. Fischer
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  3. Giorgio Tamborrini
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  4. Diego Kyburz
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  5. Katrin D. M. Stumpe
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  7. A. Johayem
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  8. Gustav K. von Schulthess
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  9. Beat A. Michel
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  10. Adrian Ciurea
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Correspondence to Klaus Strobel.

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Strobel, K., Fischer, D.R., Tamborrini, G. et al. 18F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis. Eur J Nucl Med Mol Imaging 37, 1760–1765 (2010). https://doi.org/10.1007/s00259-010-1464-7

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  • DOI: https://doi.org/10.1007/s00259-010-1464-7

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