Download PDF
CC BY-NC-ND 4.0 · World J Nucl Med 2016; 15(02): 85-90
DOI: 10.4103/1450-1147.174698
Original article

18F-sodium fluoride PET-CT hybrid imaging of the lumbar facet joints: Tracer uptake and degree of correlation to CT-graded arthropathy

Marc Mabray
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
,
Marcel Brus-Ramer
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
,
Spencer Behr
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
,
Miguel Pampaloni
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
,
Sharmila Majumdar
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
,
William Dillon
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
,
Jason Talbott
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
› Author Affiliations
› Further Information
  PDF Download Permissions and Reprints

We aim to evaluate 18F-NaF uptake by facet joints with hybrid PET-CT technique. Specifically, we evaluate NaF uptake in the facet joints of the lower lumbar spine, and correlate with the morphologic grade of facet arthropathy on CT. 30 consecutive patients who underwent standard vertex to toes NaF PET-CT for re-staging of primary neoplastic disease without measurable or documented bony metastases were identified. Maximum (SUVmax) and average (SUVavg) standardized uptake values were calculated for each L3-4, L4-5, and L5-S1 facet joint (n = 180) and normalized to average uptake in the non-diseased femur. A Pathria grade (0-3) was assigned to each facet based upon the CT morphology. Spearman′s rank correlation was performed for normalized SUVmax and SUVavg with Pathria grade. ANOVA was performed with Tukey-Kramer pairwise tests to evaluate differences in uptake between Pathria groups. Facet normalized SUVmax (r = 0.31, P < 0.001) and SUVavg (r = 0.28, P < 0.001) demonstrated a mild positive correlation with CT Pathria grade. There was a wide range of uptake values within each Pathria grade subgroup with statistically significant differences in uptake only between Pathria grade 3 as compared to grades 0, 1, and 2. In conclusion, NaF uptake and morphologic changes of the facet joint on CT are weakly correlated. Physiologic information provided by NaF uptake is often discrepant with structural findings on CT suggesting NaF PET may supplement conventional structural imaging for identification of pain generating facet joints. Prospective investigation into the relationship of facet joint NaF uptake with pain and response to pain interventions is warranted.

Keywords

Lumbar facet - sodium fluoride positron emission tomography - positron emission tomography-computed tomography - 18F-sodium fluoride


Publication History

Article published online:
19 May 2022

© 2016. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India