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Abstract
OBJECTIVE The aim of this article is to present examples in which sodium fluoride labelled with 18F (NaF) bone PET/CT would be a useful adjunct to guide complex clinical decisions about the staging, restaging, and treatment approach for patients with skeletal metastases and benign causes of NaF activity that can be mistaken for bone metastases. We present a pictorial review of selected cases of this cohort of patients. CONCLUSION NaF PET/CT hybrid fusion imaging is extremely useful in identifying potential causes of pain in patients with malignancies that have an affinity for skeletal metastases. This technique can help detect bone metastases, in problem solving, and to direct appropriate management.
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Hendrickx G, Borra VM, Steenackers E, Yorgan TA, Hermans C, Boudin E, Waterval JJ, Jansen IDC, Aydemir TB, Kamerling N, Behets GJ, Plumeyer C, D’Haese PC, Busse B, Everts V, Lammens M, Mortier G, Cousins RJ, Schinke T, Stokroos RJ, Manni JJ, Van Hul W. Conditional mouse models support the role of SLC39A14 (ZIP14) in Hyperostosis Cranialis Interna and in bone homeostasis. PLoS Genet 2018; 14:e1007321. [PMID: 29621230 PMCID: PMC5903675 DOI: 10.1371/journal.pgen.1007321] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/17/2018] [Accepted: 03/19/2018] [Indexed: 01/19/2023] Open
Abstract
Hyperostosis Cranialis Interna (HCI) is a rare bone disorder characterized by progressive intracranial bone overgrowth at the skull. Here we identified by whole-exome sequencing a dominant mutation (L441R) in SLC39A14 (ZIP14). We show that L441R ZIP14 is no longer trafficked towards the plasma membrane and excessively accumulates intracellular zinc, resulting in hyper-activation of cAMP-CREB and NFAT signaling. Conditional knock-in mice overexpressing L438R Zip14 in osteoblasts have a severe skeletal phenotype marked by a drastic increase in cortical thickness due to an enhanced endosteal bone formation, resembling the underlying pathology in HCI patients. Remarkably, L438R Zip14 also generates an osteoporotic trabecular bone phenotype. The effects of osteoblastic overexpression of L438R Zip14 therefore mimic the disparate actions of estrogen on cortical and trabecular bone through osteoblasts. Collectively, we reveal ZIP14 as a novel regulator of bone homeostasis, and that manipulating ZIP14 might be a therapeutic strategy for bone diseases.
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Affiliation(s)
- Gretl Hendrickx
- Center of Medical Genetics, University and University Hospital of Antwerp, Antwerp, Belgium
| | - Vere M. Borra
- Center of Medical Genetics, University and University Hospital of Antwerp, Antwerp, Belgium
| | - Ellen Steenackers
- Center of Medical Genetics, University and University Hospital of Antwerp, Antwerp, Belgium
| | - Timur A. Yorgan
- Department of Osteology and Biomechanics (IOBM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christophe Hermans
- Center for Oncological Research Antwerp (CORE), University of Antwerp, Antwerp, Belgium
| | - Eveline Boudin
- Center of Medical Genetics, University and University Hospital of Antwerp, Antwerp, Belgium
| | - Jérôme J. Waterval
- Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ineke D. C. Jansen
- Department of Periodontology and Oral Cell Biology, Academic Center of Dentistry Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Tolunay Beker Aydemir
- Food Science and Human Nutrition Department and Center for Nutritional Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL, United States of America
| | - Niels Kamerling
- Department of Neurosurgery, University Hospital Antwerp, Antwerp, Belgium
| | - Geert J. Behets
- Department of Pathophysiology, University of Antwerp, Antwerp, Belgium
| | - Christine Plumeyer
- Department of Osteology and Biomechanics (IOBM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Björn Busse
- Department of Osteology and Biomechanics (IOBM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vincent Everts
- Department of Periodontology and Oral Cell Biology, Academic Center of Dentistry Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Martin Lammens
- Department of Pathological Anatomy, University Hospital Antwerp, Antwerp, Belgium
| | - Geert Mortier
- Center of Medical Genetics, University and University Hospital of Antwerp, Antwerp, Belgium
| | - Robert J. Cousins
- Food Science and Human Nutrition Department and Center for Nutritional Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL, United States of America
| | - Thorsten Schinke
- Department of Osteology and Biomechanics (IOBM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert J. Stokroos
- Department of Otorhinolaryngology and Head & Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Johannes J. Manni
- Department of Otorhinolaryngology and Head & Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Wim Van Hul
- Center of Medical Genetics, University and University Hospital of Antwerp, Antwerp, Belgium
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Comparative diagnostic value of 18F-fluoride PET-CT versus MRI for skull-base bone invasion in nasopharyngeal carcinoma. Nucl Med Commun 2017; 37:1062-8. [PMID: 27159589 DOI: 10.1097/mnm.0000000000000545] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study compared the diagnostic value of F-fluoride PET-computed tomography (PET-CT) and MRI in skull-base bone erosion in nasopharyngeal carcinoma (NPC) patients. METHODS A total of 93 patients with biopsy-confirmed NPC were enrolled, including 68 men and 25 women between 23 and 74 years of age. All patients were evaluated by both F-fluoride PET-CT and MRI, and the interval between the two imaging examinations was less than 20 days. The patients received no treatment either before or between scans. The studies were interpreted by two nuclear medicine physicians or two radiologists with more than 10 years of professional experience who were blinded to both the diagnosis and the results of the other imaging studies. The reference standard was skull-base bone erosion at a 20-week follow-up imaging study. RESULTS On the basis of the results of the follow-up imaging studies, 52 patients showed skull-base bone erosion. The numbers of true positives, false positives, true negatives, and false negatives with F-fluoride PET-CT were 49, 4, 37, and 3, respectively. The numbers of true positives, false positives, true negatives, and false negatives with MRI were 46, 5, 36, and 6, respectively. The sensitivity, specificity, and crude accuracy of F-fluoride PET-CT were 94.23, 90.24, and 92.47%, respectively; for MRI, these values were 88.46, 87.80, and 88.17%. Of the 52 patients, 43 showed positive findings both on F-fluoride PET-CT and on MRI. Within the patient cohort, F-fluoride PET-CT and MRI detected 178 and 135 bone lesions, respectively. CONCLUSION Both F-fluoride PET-CT and MRI have high sensitivity, specificity, and crude accuracy for detecting skull-base bone invasion in patients with NPC. F-fluoride PET-CT detected more lesions than did MRI in the skull-base bone. This suggests that F-fluoride PET-CT has a certain advantage in evaluating the skull-base bone of NPC patients. Combining the two methods could improve the diagnostic accuracy of skull-base bone invasion for NPC.
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Bastawrous S, Bhargava P, Behnia F, Djang DSW, Haseley DR. Newer PET application with an old tracer: role of 18F-NaF skeletal PET/CT in oncologic practice. Radiographics 2015; 34:1295-316. [PMID: 25208282 DOI: 10.1148/rg.345130061] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The skeleton is one of the most common sites for metastatic disease, particularly from breast and prostate cancer. Bone metastases are associated with considerable morbidity, and accurate imaging of the skeleton is important in determining the appropriate therapeutic plan. Sodium fluoride labeled with fluorine 18 (sodium fluoride F 18 [(18)F-NaF]) is a positron-emitting radiopharmaceutical first introduced several decades ago for skeletal imaging. (18)F-NaF was approved for clinical use as a positron emission tomographic (PET) agent by the U.S. Food and Drug Administration in 1972. The early use of this agent was limited, given the difficulties of imaging its high-energy photons on the available gamma cameras. For skeletal imaging, it was eventually replaced by technetium 99m ((99m)Tc)-labeled agents because of the technical limitations of (18)F-NaF. During the past several years, the widespread availability and implementation of hybrid PET and computed tomographic (CT) dual-modality systems (PET/CT) have encouraged a renewed interest in (18)F-NaF PET/CT for routine clinical use in bone imaging. Because current PET/CT systems offer high sensitivity and spatial resolution, the use of (18)F-NaF has been reevaluated for the detection of malignant and nonmalignant osseous disease. Growing evidence suggests that (18)F-NaF PET/CT provides increased sensitivity and specificity in the detection of bone metastases. Furthermore, the favorable pharmacokinetics of (18)F-NaF, combined with the superior imaging characteristics of PET/CT, supports the routine clinical use of (18)F-NaF PET/CT for oncologic imaging for skeletal metastases. In this article, a review of the indications, imaging appearances, and utility of (18)F-NaF PET/CT in the evaluation of skeletal disease is provided, with an emphasis on oncologic imaging.
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Affiliation(s)
- Sarah Bastawrous
- From the Department of Radiology, University of Washington School of Medicine, Seattle, Wash (S.B., P.B., F.B.); Department of Radiology, VA Puget Sound Health Care System, Mail Box 358280, S-114/Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597 (S.B., P.B.); and Seattle Nuclear Medicine, Seattle, Wash (D.S.W.D., D.R.H.)
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Abstract
The use of (18)F-sodium fluoride ((18)F-NaF) with PET/CT is increasing. This resurgence of an old tracer has been fueled by several factors including superior diagnostic performance over standard (99m)Tc-based bone scintigraphy, growth in the availability of PET/CT imaging systems, increase in the number of regional commercial distribution centers for PET radiotracers, the recent concerns about potential recurring shortages with (99m)Tc-based radiotracers, and the recent decision by the Centers for Medicare and Medicaid Services to reimburse for (18)F-NaF PET/CT for evaluation of patients with known or suspected bone metastases through the National Oncologic PET Registry. The major goal of this article is to review the current evidence on the diagnostic utility of (18)F-NaF in the imaging assessment of the bone and joint in a variety of clinical conditions.
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Affiliation(s)
- Hossein Jadvar
- PET/CT Imaging Science Center, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Bhushan Desai
- PET/CT Imaging Science Center, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Peter S Conti
- PET/CT Imaging Science Center, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Win AZ, Aparici CM. NaF18-PET/CT Imaging of Secondary Hyperparathyroidism. Nucl Med Mol Imaging 2015; 49:331-2. [PMID: 26550056 DOI: 10.1007/s13139-015-0319-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 12/29/2014] [Accepted: 01/02/2015] [Indexed: 10/24/2022] Open
Affiliation(s)
- Aung Zaw Win
- Department of Radiology, San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121 USA
| | - Carina Mari Aparici
- Department of Radiology, University California San Francisco (UCSF), 500 Parnassus Ave, San Francisco, CA 94143 USA
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Wong KK, Piert M. Dynamic Bone Imaging with 99mTc-Labeled Diphosphonates and 18F-NaF: Mechanisms and Applications. J Nucl Med 2013; 54:590-9. [DOI: 10.2967/jnumed.112.114298] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Suenaga H, Yokoyama M, Yamaguchi K, Sasaki K. Time course of bone metabolism at the residual ridge beneath dentures observed using ¹⁸F-fluoride positron emission computerized-tomography/computed tomography (PET/CT). Ann Nucl Med 2012; 26:817-22. [PMID: 22903818 PMCID: PMC3524501 DOI: 10.1007/s12149-012-0648-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 07/31/2012] [Indexed: 11/29/2022]
Abstract
Objective Excessive pressure due to wearing mal-adapting dentures is well known to cause residual bone resorption beneath the denture. X-rays have been commonly utilized to evaluate the changes in the bone beneath the denture. However, X-ray images merely detect bone density and relatively large changes in the bone shape and structure, whereas nuclear medicine imaging can detect functional changes, which occur prior to structural changes. This article aimed to describe the time course of the bone metabolism at the residual ridge beneath the denture following denture use by 18F-fluoride positron emission computerized-tomography (PET)/computed tomography (CT) scanning. Methods Three subjects, who had a free-end edentulous mandible, were treated with a denture replacing the edentulous region of the dental arch. The metabolic changes in the residual bone beneath the denture were assessed by 18F-fluoride PET/CT imaging. 18F-fluoride PET/CT scanning was performed at baseline, and 4–6 and 13 weeks after denture use. A volume of interest (VOI) was placed on their mandibles at the edentulous region beneath the denture on the PET/CT image. CT value and mean standardized uptake value (SUV) of the VOI were calculated. The difference in the time variation between the CT value and SUV was analyzed. Results The adaptation of the denture base to the residual ridge was successful, and there was no trouble such as pain at the residual ridge beneath the denture. The SUVs of each VOI significantly increased at 4–6 weeks after denture use and then decreased at 13 weeks in all three subjects (P < 0.05; two-way ANOVA, Dunnett test). On the other hand, the CT images showed no obvious changes in the bone shape or structure beneath the dentures, and the CT values of each VOI remained static after denture use in all three subjects. Conclusions This study indicates that in the present first-time removable partial denture (RPD) users, wearing of a well-adapted RPD initially increased bone metabolism beneath the denture and then decreased it at around 13 weeks after RPD use without any bone structural changes detectable by clinical X-rays. These metabolic changes are a mechanobiological reaction to the pressure induced by RPD use.
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Affiliation(s)
- Hanako Suenaga
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
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