Early experience with fluorine-18 sodium fluoride bone PET in young patients with back pain
Early experience with fluorine-18 sodium fluoride bone PET in young patients with back pain
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DOI：
10.1097/bpo.0b013e31803409ba
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发表时间：
2007-04-01
影响因子：
1.7
通讯作者：
Treves, S. Ted
中科院分区：
文献类型：
--
作者：
Lim, Ruth;Fahey, Frederic H.;Treves, S. Ted
目的：用氟-18（F-18）氟化钠（F-18 NaF）进行的正电子发射断层扫描（PET）是锝-99m（Tc-99 m）亚甲基二膦酸盐（MDP）断层扫描的替代方法。儿科PET的经验很少，主要是在肿瘤学方面。本研究评估的作用F-18 NaF在评估年轻patients with back pain.Methods：94 F-18 NaF PET扫描进行了94例患者（27名男性，67名女性;平均年龄，15岁;范围，4-26岁）与背痛。在给予F-18 NaF（2.1 MBq/kg;最大值，148 MBq）后30分钟进行三维PET采集。结果：F-18 NaF PET显示55%（52/94）的患者可能有背痛的原因。15例患者有2个或更多潜在的背痛来源。PET诊断为峡部/椎弓根应力（34%）、棘突损伤（16%）、椎体环骨骺损伤（14%）、过渡椎-骶关节应力（7%）和骶髂关节炎症/应力（3%）。F-18 NaF PET与Tc-99 mMDP脑显像相比，注射与扫描之间的时间更短（0.5小时vs 3小时），辐射剂量测定相似（3.5 mGy vs 2.8 mGy的有效剂量为55公斤的病人为F-18 NaF和Tc-99 m MDP分别），放射性药物的成本较高。F-18 NaF骨PET可以检测年轻背痛患者的各种骨骼异常。相对于Tc-99 mMDP，图像具有更高的分辨率。从示踪剂给药到完成的总时间较短，辐射剂量测定相似。F-18 NaF的较高成本可以通过提高患者吞吐量来抵消。
Purpose: Skeletal positron emission tomography (PET) with fluorine-18 (F-18) sodium fluoride (F-18 NaF) is an alternative to technetium-99m (Tc-99m)methylene diphosphonate (MDP) scintigraphy. Experience with pediatric PET is sparse, primarily in oncology. This study assesses the role of F-18 NaF in evaluating young patients with back pain.Methods: Ninety-four F-18 NaF PET scans were performed in 94 patients (27 males, 67 females; mean age, 15 years; range, 4-26 years) with back pain. Three-dimensional PET acquisition was performed 30 minutes after administration of F-18 NaF (2.1 MBq/kg; maximum, 148 MBq). Radiation doses are presented for F-18 NaF and Tc-99m MDP.Results: F-18 NaF PET revealed a possible cause of back pain in 55% (52/94). Fifteen patients had 2 or more potential sources of back pain. Diagnoses by PET were pars interarticularis/pedicle stress (34%), spinous process injury (16%), vertebral body ring apophyseal injury (14%), stress at a transitional vertebra-sacral articulation (7%), and sacroiliac joint inflammation/stress (3%). Comparing F-18 NaF PET with Tc-99m MDP scintigraphy, time between injection and scanning was shorter (0.5 hours vs 3 hours), radiation dosimetry was similar (3.5 mGy vs 2.8 mGy effective dose for a 55-kg patient for F-18 NaF and Tc-99m MDP, respectively), and cost of radiopharmaceutical was higher.Conclusions: F-18 NaF bone PET can detect a variety of skeletal abnormalities in young patients with back pain. Relative to Tc-99m MDP, images are of higher resolution. Total time from tracer administration to completion is shorter, and radiation dosimetry is similar. Higher cost for F-18 NaF may be offset by enhanced patient throughput.