Artikel
Performance of hybrid 18F-fluoride PET/MRI of the sacroiliac joints and the spine in patients with axial spondyloarthritis
Suche in Medline nach
Autoren
Veröffentlicht: | 12. September 2014 |
---|
Gliederung
Text
Background: To examine whether inflammatory or chronic changes assessed by magnetic resonance imaging (MRI) in sacroiliac joints (SIJ) and spine of patients with active ankylosing spondylitis (AS) are associated with osteoblastic activity, as assessed by 18F-Fluoride uptake in positron emission tomography/MRI (PET/MRI).
Methods: Thirteen AS patients (mean age 37.8±11.4 years, BASDAI>4, no anti-TNF treatment) underwent 3-Tesla integrated whole-spine 18F-Fluoride (18F-F) PET/MRI. Two independent readers recorded pathologic changes related to vertebral- (VQ) or SIJ-quadrants (SQ) for bone marrow edema (BME) and fatty degeneration (FD). Final scores based on agreement.
Results: A total of 104 SQs and 1,196 VQs were examined. In the SIJ, BME was seen in 44.2%, FD in 42.3% and 18F-F uptake in 46.2% SQs. BME alone was associated with 18F-F uptake in 78.6% and FD alone in only 7.7% SQs, while the combination BME/FD was associated with 18F-F uptake in 72.2% SQs. In contrast, erosions, sclerosis, and ankylosis alone were rarely associated with 18F-F uptake. In the spine, BME alone was seen in 9.9%, FD in 18.2% and 18F-F uptake in 5.4% VQs. BME alone was associated with 18F-F uptake in 14.3% and FD alone in 8.7% VQs, while the combination BME/FD was associated with 18F-F uptake in 40.6% VQs. Overall, 18F-F uptake alone was found in 25% of SQs and VQs.
Conclusion: This is the first study on hybrid 18F-F PET-MRI in patients with active AS. We show that the inflammatory rather than the chronic changes are associated with osteoblastic activity. The observation that the combination of BME and FD in the spine showed the highest 18F-F uptake is consistent with our previous finding that this combination is the strongest predictor of future syndesmophyte formation.