18 F-FPRGD 2 PET/CT imaging of musculoskeletal disorders
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ORIGINAL ARTICLE
18
F-FPRGD2 PET/CT imaging of musculoskeletal disorders
Nadia Withofs1 • Edith Charlier2 • Paolo Simoni3 • Victoria Alvarez-Miezentseva3 Fre´de´ric Mievis4 • Fabrice Giacomelli4 • Christine Mella4 • Sanjiv S. Gambhir5 • Olivier Malaise2 • Dominique de Seny2 • Michel Malaise2 • Roland Hustinx1
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Received: 2 June 2015 / Accepted: 26 July 2015 Ó The Japanese Society of Nuclear Medicine 2015
N. Withofs, E. Charlier, M. Malaise and R. Hustinx equally contributed to the work.
Results A total of 260 musculoskeletal foci of 18FFPRGD2 uptake were detected. Most common sites of uptake were joints and discs (n = 160; 61.5 %), entheses (osteotendinous and osteoligamentous junctions; n = 55; 21.2 %) and recent fractures (n = 18; 6.9 %). In addition, 27 (10.4 %) miscellaneous foci were detected. Out of the 146 lesions for which a FDG PET was available, 63 % showed both 18F-FPRGD2 and FDG uptake, 33.6 % did not show FDG avidity and 3.4 % showed only FDG uptake. The uptake intensity of the 92 lesions positive with 18FFPRGD2 and FDG was similar with both radiopharmaceuticals, but the target-to-background (blood pool or muscle) ratios were significantly higher with 18F-FPRGD2 than with FDG (p \ 0.0001). Conclusion The 18F-FPRGD2 uptake in joints, spine degenerative diseases and tendons was highly prevalent in our population. Up to one-third of 18F-FPRGD2 foci showed no FDG uptake suggesting that 18F-FPRGD2 signal may not be related to inflammatory angiogenesis only.
Electronic supplementary material The online version of this article (doi:10.1007/s12149-015-1011-5) contains supplementary material, which is available to authorized users.
Keywords RGD PET Integrin Osteoarthritis Discopathy Joint
Abstract Objective This work reports on musculoskeletal uptake of 18 F-FPRGD2, targeting the integrin avb3, in patients who had undergone 18F-FPRGD2 positron emission tomography combined with computed tomography (PET/CT) for oncologic purposes. Methods Whole-body 18F-FPRGD2 PET/CT images of 62 cancer patients were retrospectively reviewed to detect foci of musculoskeletal 18F-FPRGD2 uptake. For 37 patients, a FDG PET/CT performed in clinical settings was available. In each joint with an abnormal uptake, the maximum standardized uptake value (SUVmax) was estimated.
& Nadia Withofs [email protected] 1
Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, CHU Liege, Liege, Belgium
2
Department and Laboratory of Rheumatology CHU Liege and GIGA-Research, University of Liege, Liege, Belgium
3
Division of Diagnostic Imaging, Department of Medical Physics, CHU Liege, Liege, Belgium
4
Cyclotron Research Centre, University of Liege, Liege, Belgium
5
Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University, Stanford, CA, USA
Introduction Age-related musculoskeletal diseases are a major concern in our ever-increasing elderly population as they are responsible for pain, loss of function and disability [1]. Osteoarthritis (OA) is more than a
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