Abstract
PurposeThe purpose of this study is to compare dynamic and static whole-body (WB) [18F]NaF PET/CT scan methods used for analysis of bone plasma clearance in patients with chronic kidney disease-mineral and bone disorder (CKD-MBD).MethodsSeventeen patients with CKD-MBD underwent a 60-min dynamic scan followed by a 30-min static WB scan. Tracer kinetics in four thoracic vertebrae were analysed using nonlinear regression and Patlak analysis using image-derived arterial input functions. The static WB scan was analysed using a simplified Patlak method requiring only a single data point in combination with a fixed y-intercept value (V0), both obtained using a semi-population function. The semi-population function was constructed by combining a previously derived population input function in combination with data from venous blood samples. Static WB scan analysis data, obtained from the semi-population input functions, was compared with paired data obtained using dynamic input functions.ResultsBone plasma clearance (Ki) from Patlak analyses correlated well with nonlinear regression analysis, but Ki results using Patlak analysis were lower than Ki results using nonlinear regression analysis. However, no significant difference was found between Ki obtained by static WB scans and Ki obtained by dynamic scans using nonlinear regression analysis (p = 0.29).ConclusionBone plasma clearance measured from static WB scans correlates with clearance data measured by dynamic analysis. Static [18F]NaF PET/CT scans can be applied in future studies to measure Ki in patients with CKD-MBD, but the results should not be compared uncritically with results obtained by dynamic scan analysis.
Highlights
Fluorine-18 labelled sodium fluoride (18F-NaF) was introduced in the 1960s as a bone-seeking tracer in nuclear medicine [1] and has been widely used for gamma camera bone scintigraphy
The mean recovery coefficient β was 0.69 ± 0.15 when the image-derived arterial input function (IDAIF) was obtained from time activity curves (TACs) in the left ventricle (LV)
A dynamic scan protocol using the two-tissue compartment model with robust mean Ki- and K1–4 values has been established, and it was observed that the resulting Ki values using Patlak analysis were lower than the values obtained from the two-tissue compartment model
Summary
Fluorine-18 labelled sodium fluoride (18F-NaF) was introduced in the 1960s as a bone-seeking tracer in nuclear medicine [1] and has been widely used for gamma camera bone scintigraphy. Chronic kidney disease (CKD) is associated with universal bone abnormalities (renal osteodystrophy) and disturbances in mineral metabolism leading to cardiovascular and extra-skeletal calcifications. Even though bone-related complications have been known in CKD since 1883 [4], the key to effective treatment and prevention remains to be found This shortcoming can be possibly attributed to the lack of non-invasive methods available for research in this field, as recruitment to, for example, new treatment monitoring studies which include bone biopsy, is at best difficult
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