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Thivat E, Chanchou M, Mathieu S, Levesque S, Billoux T, Auzeloux P, Sas N, Molnar I, Jouberton E, Rouanet J, Fois G, Maigne L, Galmier MJ, Penault-Llorca F, Miot-Noirault E, Durando X, Cachin F. Assessment of 99mTc-NTP 15-5 uptake on cartilage, a new proteoglycan tracer: Study protocol for a phase I trial (CARSPECT). Front Med (Lausanne) 2022; 9:993151. [PMID: 36314021 PMCID: PMC9596979 DOI: 10.3389/fmed.2022.993151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022] Open
Abstract
Background 99mTc-NTP 15-5 is a SPECT radiotracer targeting proteoglycans (PG), components of the cartilaginous extracellular matrix. Imaging of PGs would be useful for the early detection of cartilage disorders (osteoarthritis, arthritis and chondrosarcoma, Aromatase Inhibitor associated arthralgia (AIA) in breast cancer), and the follow-up of patients under treatment. According to preclinical study results, 99mTc-NTP 15-5, is a good candidate for a specific functional molecular imaging of joints. We intend to initiate a first in-human study to confirm and quantify 99mTc-NTP 15-5 uptake in healthy joints. Methods As the clinical development of this radiotracer would be oriented toward the functional imaging of joint pathologies, we have chosen to include patients with healthy joints (unilateral osteoarthritis of the knee or breast cancer with indication of AI treatment). This phase I study will be an open-label, multicenter, dose-escalation trial of a radiopharmaceutical orientation to determine the recommended level of activity of 99mTc-NTP 15-5 to obtain the best joint tracer contrasts on images, without dose limiting toxicity (DLT). The secondary objectives will include the study of the pharmacology, biodistribution (using planar whole body and SPECT-CT acquisitions), toxicity, and dosimetry of this radiotracer. The dose escalation with 3 activity levels (5, 10, and 15 MBq/kg), will be conditioned by the absence at the previous level of DLT and of a visualized tracer accumulation on more than 80% of healthy joints as observed on scintigraphy performed at ≤ 2 h post-injection. Discussion This first in-human phase I trial will be proof-of-concept of the relevance of 99mTc-NTP 15-5 as a cartilage tracer, with the determination of the optimal methodology (dose and acquisition time) to obtain the best contrast to provide a functional image of joints with SPECT-CT. Trial registration number Clinicaltrials.gov: NCT04481230. Identifier in French National Agency for the Safety of Medicines and Health Products (ANSM): N°EudraCT 2020-000495-37.
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Affiliation(s)
- Emilie Thivat
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Département de Recherche Clinique, Centre Jean PERRIN, Clermont-Ferrand, France,Centre d'Investigation Clinique UMR501, Clermont-Ferrand, France,*Correspondence: Emilie Thivat
| | - Marion Chanchou
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Service de Médecine Nucléaire, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Sylvain Mathieu
- Service de Rhumatologie, Centre Hospitalier Universitaire (CHU) Gabriel Montpied, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Sophie Levesque
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Département de Recherche Clinique, Centre Jean PERRIN, Clermont-Ferrand, France,Unité de Radiopharmacie, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Tommy Billoux
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Service de Physique Médicale, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Philippe Auzeloux
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Nicolas Sas
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Service de Physique Médicale, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Ioana Molnar
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Département de Recherche Clinique, Centre Jean PERRIN, Clermont-Ferrand, France,Centre d'Investigation Clinique UMR501, Clermont-Ferrand, France
| | - Elodie Jouberton
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Service de Médecine Nucléaire, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Jacques Rouanet
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Service de Dermatologie et d'Oncologie Cutanée, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
| | - Giovanna Fois
- Laboratoire de Physique de Clermont, UMR6533, Centre National de la Recherche Scientifique (CNRS)/Institut National de Physique Nucléaire et de Physique des Particules (IN2P3), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Lydia Maigne
- Laboratoire de Physique de Clermont, UMR6533, Centre National de la Recherche Scientifique (CNRS)/Institut National de Physique Nucléaire et de Physique des Particules (IN2P3), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Marie-Josephe Galmier
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Frédérique Penault-Llorca
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Centre d'Investigation Clinique UMR501, Clermont-Ferrand, France,Département de Biopathologie, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Elisabeth Miot-Noirault
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Xavier Durando
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Département de Recherche Clinique, Centre Jean PERRIN, Clermont-Ferrand, France,Centre d'Investigation Clinique UMR501, Clermont-Ferrand, France,Département d'oncologie Médicale, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Florent Cachin
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1240 Imagerie Moléculaire et Stratégies Theranostiques (IMoST), Université Clermont Auvergne, Clermont-Ferrand, France,Centre d'Investigation Clinique UMR501, Clermont-Ferrand, France,Service de Médecine Nucléaire, Centre Jean PERRIN, Clermont-Ferrand, France
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99mTc-NTP 15-5 is a companion radiotracer for assessing joint functional response to sprifermin (rhFGF-18) in a murine osteoarthritis model. Sci Rep 2022; 12:8146. [PMID: 35581224 PMCID: PMC9113995 DOI: 10.1038/s41598-022-11080-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/13/2022] [Indexed: 02/03/2023] Open
Abstract
With the emergence of disease modifying osteoarthritis drugs (DMOAD), imaging methods to quantitatively demonstrate their efficacy and to monitor osteoarthritis progression at the functional level are urgently needed. Our group showed that articular cartilage can be quantitatively assessed in nuclear medicine imaging by our radiotracer 99mTc-NTP 15-5 targeting cartilage proteoglycans. In this work, surgically induced DMM mice were treated with sprifermin or saline. We investigated cartilage remodelling in the mice knees by 99mTc-NTP 15-5 SPECT-CT imaging over 24 weeks after surgery, as wells as proteoglycan biochemical assays. OA alterations were scored by histology according to OARSI guidelines. A specific accumulation of 99mTc-NTP 15-5 in cartilage joints was evidenced in vivo by SPECT-CT imaging as early as 30 min post-iv injection. In DMM, 99mTc-NTP 15-5 accumulation in cartilage within the operated joints, relative to contralateral ones, was observed to initially increase then decrease as pathology progressed. Under sprifermin, 99mTc-NTP 15-5 uptake in pathological knees was significantly increased compared to controls, at 7-, 12- and 24-weeks, and consistent with proteoglycan increase measured 5 weeks post-surgery, as a sign of cartilage matrix remodelling. Our work highlights the potential of 99mTc-NTP 15-5 as an imaging-based companion to monitor cartilage remodelling in OA and DMOAD response.
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Abstract
BACKGROUND Single photon emission computed tomography (SPECT/CT) is a diagnostic option for knee osteoarthritis patients without osteoarthritic features on X-ray; however, the added value of SPECT/CT remains debatable in the diagnostic algorithm. OBJECTIVE To review the added value of SPECT/CT in the diagnostic algorithm of knee osteoarthritis. STUDY DESIGN Systematic review. METHODS A systematic search was carried out in the databases EMBASE, MEDLINE, and the Cochrane collaboration. The retrieved articles were screened for relevance on title and abstract. This was followed by a full-text study quality appraisal of the remaining articles. Finally, a total of 9 trials were included. RESULTS The use of SPECT/CT might objectify some clinical knee osteoarthritis symptoms. It could correlate with findings on plain radiography and magnetic resonance imaging. Furthermore, there is some evidence SPECT/CT gives additional information compared with these imaging modalities; however, superiority is not proven. The uptake on SPECT could predict the intraoperative macroscopic findings. Yet the clinical relevance remains unclear. CONCLUSION There is no strong evidence SPECT/CT should play a role in the diagnosing and decision-making processes of knee osteoarthritis. Yet there is evidence suggesting SPECT/CT might give additional information in the diagnosing process. More research would be of added value to answer this research question.
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Affiliation(s)
- D. Zarringam
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - D.B.F. Saris
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA
| | - J.E.J. Bekkers
- Department of Orthopedics, Diakonessenhuis Hospital, Utrecht, The Netherlands,J. E. J. Bekkers, Clinical Orthopedic Research Center–midden Nederland (CORC-mN), Department of Orthopedics, Diakonessenhuis Hospital, Bosboomstraat 1, Utrecht, 3582 KE, The Netherlands.
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Fois GR, Valla C, Jouberton E, Sas N, Billoux T, Auzeloux P, Cachin F, Miot-Noirault E, Maigne L. Internal dosimetry of [ 99m Tc]NTP15-5 radiotracer for cartilage imaging in preclinical and clinical models using the GATE Monte Carlo platform. Med Phys 2020; 48:477-487. [PMID: 33217001 DOI: 10.1002/mp.14603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/21/2020] [Accepted: 10/21/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study aims to perform dosimetry for [99m Tc]NTP15-5 radiotracer used in imaging of articular cartilage in rabbits and humans. The radiotracer (covered by a world patent WO 01/00621 A1) has been proposed in the previous years for the study of cartilage in osteoarthritis diseases. A sensitive imaging approach is essential to quantify osteoarthritis progression and monitor response to new therapies. [99m Tc]NTP15-5 binds to cartilage proteoglycans whose decreased content is associated to a loss of biomedical function of cartilage. We have implemented the whole dosimetry study concerning this new radiotracer for rabbits and humans using the GATE Monte Carlo platform. MATERIALS AND METHODS Absorbed doses to critical organs are determined using the MIRD formalism. Biodistribution data are obtained by organ sampling, measuring the activity in organs for three rabbits sacrificed at various times postadministration, and by SPECT/CT imaging at different times after injection. Most important sources are cartilages (in knees and intervertebral discs), due to localization together with the liver and kidneys due to excretion of the agent. S-values are calculated from rabbit's CT scan and human CT scan using the GATE v8.0 Monte Carlo platform. Cumulated activity in humans is extrapolated from animals using the %kg-dose/g method. Particular attention is given to dose calculation in bones, bone marrow and organs at risk. RESULTS The dosimetry performed in rabbits shows highest absorbed doses for liver and kidneys with respectively 22.5 and 43.8 µGy per MBq of injected activity. In humans, we found absorbed doses for a maximum injected activity of 15 MBq/kg, that is, 1050 MBq for an adult of 70 kgs of 9.03 mGy for kidneys and 4.16 mGy for knee cartilages. Effective dose is 2.69 µSv/MBq. CONCLUSIONS The dosimetry profile of [99m Tc]NTP15-5 in the context of preclinical trials is of major importance in order to make sure that organs at risk are not overexposed. GATE provides all the capability needed to calculate dose profiles for internal dosimetry. The extrapolation of the dose for a human model is a first step towards clinical trials.
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Affiliation(s)
- Giovanna Rosa Fois
- Université Clermont Auvergne, CNRS/IN2P3, Laboratoire de Physique de Clermont, UMR6533, 4 avenue Blaise Pascal TSA 60026 CS, Clermont-Ferrand, Aubière cedex, 60026 63178, France
| | - Clémence Valla
- Université Clermont Auvergne, INSERM, Imagerie Moléculaire et Stratégies Théranostiques, UMR1240, 58 Rue Montalembert, Clermont-Ferrand cedex, 63 005, France.,Centre Jean Perrin, Clermont-Ferrand, 63011, France
| | - Elodie Jouberton
- Université Clermont Auvergne, INSERM, Imagerie Moléculaire et Stratégies Théranostiques, UMR1240, 58 Rue Montalembert, Clermont-Ferrand cedex, 63 005, France.,Centre Jean Perrin, Clermont-Ferrand, 63011, France
| | - Nicolas Sas
- Centre Jean Perrin, Clermont-Ferrand, 63011, France
| | | | - Philippe Auzeloux
- Université Clermont Auvergne, INSERM, Imagerie Moléculaire et Stratégies Théranostiques, UMR1240, 58 Rue Montalembert, Clermont-Ferrand cedex, 63 005, France
| | - Florent Cachin
- Université Clermont Auvergne, INSERM, Imagerie Moléculaire et Stratégies Théranostiques, UMR1240, 58 Rue Montalembert, Clermont-Ferrand cedex, 63 005, France.,Centre Jean Perrin, Clermont-Ferrand, 63011, France
| | - Elisabeth Miot-Noirault
- Université Clermont Auvergne, INSERM, Imagerie Moléculaire et Stratégies Théranostiques, UMR1240, 58 Rue Montalembert, Clermont-Ferrand cedex, 63 005, France.,Centre Jean Perrin, Clermont-Ferrand, 63011, France
| | - Lydia Maigne
- Université Clermont Auvergne, CNRS/IN2P3, Laboratoire de Physique de Clermont, UMR6533, 4 avenue Blaise Pascal TSA 60026 CS, Clermont-Ferrand, Aubière cedex, 60026 63178, France
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Akbar MU, Ahmad MR, Shaheen A, Mushtaq S. A review on evaluation of technetium-99m labeled radiopharmaceuticals. J Radioanal Nucl Chem 2016. [DOI: 10.1007/s10967-016-5019-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Conventional and novel imaging modalities in osteoarthritis: current state of the evidence. Curr Opin Rheumatol 2015; 27:295-303. [PMID: 25803224 DOI: 10.1097/bor.0000000000000163] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Imaging modalities are currently an inseparable part of osteoarthritis diagnosis. In this review, we describe the current state of evidence regarding conventional and novel imaging modalities in evaluation of osteoarthritis. Modalities including radiography (qualitative and semi-quantitative assessments), ultrasonography, computed tomography [CT; conventional multidetector CT (MDCT), cone-beam CT (CBCT) and four-dimensional CT (4DCT)], MRI (MRI; semi-quantitative, quantitative and compositional) and PET and their applications are reviewed. RECENT FINDINGS Radiography is the modality of choice for initial assessment of osteoarthritis. However, due to its low sensitivity and specificity, numerous recent investigations have proposed MRI as a powerful addition to detect and grade osteoarthritis features, which are not apparent in radiography. Semi-quantitative MRI measurements are feasible to perform in routine clinical practice. Quantitative and compositional MRI measurements have extended the amount of information an MRI examination can provide regarding the three-dimensional shape and tissue composition of articular cartilage. 4DCT and CBCT are introduced as imaging examinations that may reveal biomechanical cartilage abnormalities in osteoarthritis joint by dynamic and weight-bearing evaluations, respectively. Recent PET studies may unveil the underlying metabolic activities that can be associated with osteoarthritis. SUMMARY In addition to the established role of radiographs, MRI is the advanced modality of choice for detection and quantification of various osteoarthritis features. 4DCT and CBCT may have specified applications when diagnosis of underlying motion abnormality or dynamic changes in weight-bearing situation is suspected. Future studies should elucidate the specific clinical applications of ultrasonography and PET.
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Vidal A, Gaumet V, Galmier MJ, Besse S, Leal F, Gachon F, Viot G, Métin J, Chezal JM, Miot-Noirault E, Auzeloux P. Development of a freeze-dried kit formulation for the preparation of 99m Tc-NTP 15-5, a radiotracer for scintigraphic imaging of proteoglycans. Appl Radiat Isot 2015; 101:1-9. [DOI: 10.1016/j.apradiso.2015.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/03/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
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Khairnar A, Marchand F, Vidal A, Etienne M, Miladi I, Auzeloux P, Cachin F, Eschalier A, Chezal JM, Ardid D, Miot-Noirault E. 99mTc-NTP 15-5 Imaging for Cartilage Involvement in Experimental Rheumatoid Arthritis: Comparison with Routinely Used Molecular Imaging Methods and Sensitivity to Chronic Nonsteroidal Antiinflammatory Drug Treatment. J Nucl Med 2015; 56:798-804. [PMID: 25840975 DOI: 10.2967/jnumed.114.151415] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 02/10/2015] [Indexed: 01/01/2023] Open
Abstract
UNLABELLED This study determined, using the intraarticular complete Freund adjuvant arthritis mice model, whether the radiotracer (99m)Tc-N-(triethylammonium)-3-propyl-[15]ane-N5 ((99m)Tc-NTP 15-5) targeting proteoglycans has a pathophysiologic validity for in vivo imaging of rheumatoid arthritis (RA) and its response to chronic nonsteroidal antiinflammatory drugs. METHODS We investigated the time course of cartilage remodeling by (99m)Tc-NTP 15-5 scintigraphy, bone damages by (99m)Tc-hydroxymethylene diphosphonate imaging, inflammation by (18)F-FDG PET, and joint proteoglycan content and pain behavior in animals, without and with meloxicam treatment. Paw circumference, thermal pain behavior, and histology as well as proteoglycan content of the whole joint were determined. RESULTS (99m)Tc-NTP 15-5 showed specific tracer accumulation within RA joints, with a significant increase in scintigraphic ratio observed in RA versus shams from day 3 to day 28. (18)F-FDG evidenced uptake in RA joints from day 15 to day 29. Animals treated with meloxicam (5 mg/kg) exhibited a dose-dependent decrease in both (99m)Tc-NTP 15-5 and (18)F-FDG uptake ratios versus saline-treated animals. (99m)Tc-hydroxymethylene diphosphonate bone scans were only positive at day 14 in RA versus shams, with a significant effect of meloxicam. An increase in proteoglycans of RA joint and thermal pain behavior were observed and were dose-dependently reduced by meloxicam. CONCLUSION These experimental results bring data in favor of the (99m)Tc-NTP 15-5 radiotracer for assessing, in vivo, cartilage remodeling in RA that could be used to monitor therapy.
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Affiliation(s)
- Amit Khairnar
- Clermont Université, Université d'Auvergne, Imagerie Moléculaire et Thérapie Vectorisée, BP 10448, Clermont-Ferrand, France INSERM, U 990, Clermont-Ferrand, France Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, Clermont-Ferrand, France INSERM U1107 NEURO-DOL, Clermont-Ferrand, France; and
| | - Fabien Marchand
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, Clermont-Ferrand, France INSERM U1107 NEURO-DOL, Clermont-Ferrand, France; and
| | - Aurélien Vidal
- Clermont Université, Université d'Auvergne, Imagerie Moléculaire et Thérapie Vectorisée, BP 10448, Clermont-Ferrand, France INSERM, U 990, Clermont-Ferrand, France
| | - Monique Etienne
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, Clermont-Ferrand, France INSERM U1107 NEURO-DOL, Clermont-Ferrand, France; and
| | - Imen Miladi
- Clermont Université, Université d'Auvergne, Imagerie Moléculaire et Thérapie Vectorisée, BP 10448, Clermont-Ferrand, France INSERM, U 990, Clermont-Ferrand, France
| | - Philippe Auzeloux
- Clermont Université, Université d'Auvergne, Imagerie Moléculaire et Thérapie Vectorisée, BP 10448, Clermont-Ferrand, France INSERM, U 990, Clermont-Ferrand, France
| | - Florent Cachin
- Clermont Université, Université d'Auvergne, Imagerie Moléculaire et Thérapie Vectorisée, BP 10448, Clermont-Ferrand, France INSERM, U 990, Clermont-Ferrand, France CLCC Jean Perrin, Clermont-Ferrand, France
| | - Alain Eschalier
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, Clermont-Ferrand, France INSERM U1107 NEURO-DOL, Clermont-Ferrand, France; and
| | - Jean-Michel Chezal
- Clermont Université, Université d'Auvergne, Imagerie Moléculaire et Thérapie Vectorisée, BP 10448, Clermont-Ferrand, France INSERM, U 990, Clermont-Ferrand, France
| | - Denis Ardid
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, Clermont-Ferrand, France INSERM U1107 NEURO-DOL, Clermont-Ferrand, France; and
| | - Elisabeth Miot-Noirault
- Clermont Université, Université d'Auvergne, Imagerie Moléculaire et Thérapie Vectorisée, BP 10448, Clermont-Ferrand, France INSERM, U 990, Clermont-Ferrand, France
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Roemer FW, Eckstein F, Hayashi D, Guermazi A. The role of imaging in osteoarthritis. Best Pract Res Clin Rheumatol 2014; 28:31-60. [PMID: 24792944 DOI: 10.1016/j.berh.2014.02.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Osteoarthritis (OA) is the most prevalent joint disorder with no approved disease-modifying treatment available. The importance of imaging in assessing all joint structures involved in the disease process, including articular cartilage, meniscus, subarticular bone marrow, and synovium for diagnosis, prognostication, and follow-up, has been well recognized. In daily clinical practice, conventional radiography is still the most commonly used imaging technique for the evaluation of a patient with known or suspected OA and radiographic outcome measures are still the only approved end point by regulatory authorities in clinical trials. The ability of magnetic resonance imaging (MRI) to visualize all joint structures in three-dimensional fashion including tissue ultrastructure has markedly deepened our understanding of the natural history of the disease. This article describes the roles and limitations of different imaging modalities for clinical practice and research in OA, with a focus on radiography and MRI and an emphasis on the knee joint.
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Affiliation(s)
- Frank W Roemer
- Department of Radiology, Quantitative Imaging Center (QIC), Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, USA; Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054 Erlangen, Germany; Department of Radiology, Klinikum Augsburg, Augsburg, Stenglinstr 2, 86156 Augsburg, Germany.
| | - Felix Eckstein
- Institute of Anatomy, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria.
| | - Daichi Hayashi
- Department of Radiology, Quantitative Imaging Center (QIC), Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, USA; Department of Radiology, Bridgeport Hospital, Yale University School of Medicine, 267 Grant Street, Bridgeport, CT 06610, USA.
| | - Ali Guermazi
- Department of Radiology, Quantitative Imaging Center (QIC), Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, USA.
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Osteoarthritis: a review of strengths and weaknesses of different imaging options. Rheum Dis Clin North Am 2013; 39:567-91. [PMID: 23719076 DOI: 10.1016/j.rdc.2013.02.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Slowing of radiographic joint space narrowing represents the only recommended imaging-based outcome measure to assess structural disease progression in osteoarthritis (OA) clinical trials. There are no effective disease-modifying OA drugs. The ability of magnetic resonance (MR) to image structures within the knee and to visualize cartilage morphology and composition gives MR imaging a critical role in understanding the natural history of the disease and in the search for therapies. In this article, the roles and limitations of conventional radiography and MR imaging, focusing on knee OA, and the use of other modalities in clinical practice and OA research are described.
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Guermazi A, Hayashi D, Eckstein F, Hunter DJ, Duryea J, Roemer FW. Imaging of Osteoarthritis. Rheum Dis Clin North Am 2013; 39:67-105. [DOI: 10.1016/j.rdc.2012.10.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Saltzherr MS, Selles RW, Bierma-Zeinstra SMA, Muradin GSR, Coert JH, van Neck JW, Luime JJ. Metric properties of advanced imaging methods in osteoarthritis of the hand: a systematic review. Ann Rheum Dis 2013; 73:365-75. [DOI: 10.1136/annrheumdis-2012-202515] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Miot-Noirault E, Guicheux J, Vidal A, Gauthier O, Auzeloux P, Lesoeur J, Cachin F, Askienazy S, Chezal JM, Vinatier C. In vivo experimental imaging of osteochondral defects and their healing using (99m)Tc-NTP 15-5 radiotracer. Eur J Nucl Med Mol Imaging 2012; 39:1169-72. [PMID: 22398956 DOI: 10.1007/s00259-012-2081-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 01/31/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE A rabbit model of osteochondral defects (OD) and spontaneous healing was longitudinally followed over 12 weeks, by in vivo joint scintigraphy using (99m)Tc-NTP 15-5, and histology. METHODS We used two models, one with one OD (OD1 group) in the femoral condyle of one knee and the other with two ODs (OD2 group) in the femoral condyle of one knee, with the contralateral knees serving as the reference. A serial longitudinal imaging study was performed with the scintigraphic ratio (SR, operated knee uptake/contralateral knee uptake) determined at each time-point. RESULTS ODs were imaged as radioactive defects. The SR was decreased with respective to controls, with values of 0.73 ± 0.08 and 0.65 ± 0.07 in the OD1 and OD2 groups, respectively, at 4 weeks after surgery. Histology of both OD groups revealed the presence of repair tissue characterized by a small amount of sulphated glycosaminoglycans and collagen. CONCLUSION (99m)Tc-NTP 15-5 imaging provided quantitative criteria useful for in vivo evaluation of cartilage trauma and healing.
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Affiliation(s)
- E Miot-Noirault
- UMR 990 INSERM, Université d'Auvergne, Clermont-Ferrand, France.
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