Abstract
Our aim was to prospectively evaluate the relationship between low back pain-related disability and quantitative measures from [18F]-sodium fluoride ([18F]-NaF) MR imaging. Six patients with facetogenic low back pain underwent dynamic [18F]-NaF PET/MR imaging. PET metrics were correlated with clinical measures and MR imaging grading of lumbar facet arthropathy. A significant positive correlation was observed between maximum facet joint uptake rate and clinical disability (P < .05). These data suggest that dynamic [18F]-NaF PET may serve as a useful biomarker for facetogenic disability.
Highlights
MATERIALS AND METHODSPatient Population This prospective feasibility study recruited patients after obtaining human study institutional review board approval and complying with Health Insurance Portability and Accountability Act regulations
[18F]-NaF Uptake Measurements and MR Imaging Grading Uptake values were measured in bilateral facet joints across 5 levels in all subjects for a total of 60 measurements
[18F]-NaF PET may aid in treatment planning and longitudinal monitoring of degenerative lumbar facet disease
Summary
Patient Population This prospective feasibility study recruited patients after obtaining human study institutional review board approval and complying with Health Insurance Portability and Accountability Act regulations. The MR imaging attenuation correction for the lumbar spine region was calculated with the accepted standard 2-point Dixon method.. Data Analysis Quantitative and semiquantitative PET analysis included all facet joints from the L1–L2 to L5–S1 levels. All PET analysis was performed with PMOD licensed software (PMOD Technologies, Zurich, Switzerland) This software facilitates model-based analysis of dynamic PET data. Standard Uptake Value Calculations and Kinetic Data Placement of facet joint (FJ) VOIs is shown in On-line Fig 2A. The 2-tissue irreversible compartment model was used to calculate the regionspecific influx rate constants (in minuteϪ1) for [18F]-NaF.. The tracer influx rate from the blood pool to the bone matrix was calculated with Equation 2 for Ki_Patlak. Ki_Patlak represents the rate at which [18F]-NaF leaves the arterial blood pool and irreversibly binds to a subsite bone matrix. A 2-samples t test was used (P Ͻ .05) to assess the significance of differences in the Ki_Patlak influx rate between the mean FJmax and mean FJminimum (min) Ki_Patlak and among FJ MR imaging grades
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