Therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain (original) (raw)
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Evaluation of 18F-Fluoride PET/MR and PET/CT in Patients with Foot Pain of Unclear Cause
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2015
Our objective was to compare the quality and diagnostic performance of (18)F-fluoride PET/MR imaging with that of (18)F-fluoride PET/CT imaging in patients with foot pain of unclear cause. Twenty-two patients (9 men, 13 women; mean age, 48 ± 18 y; range, 20-78 y) were prospectively included in this study and underwent a single-injection dual-imaging protocol with (18)F-fluoride PET/CT and PET/MR. At a minimum, the PET/MR protocol included T1-weighted spin echo and proton-density fat-saturated sequences in 2 planes each with simultaneous acquisition of PET over 20 min. PET/CT included a native isotropic (0.6 mm) diagnostic CT scan (80 kV, 165 mAs) and a subsequent PET scan (2 min per bed position). By consensus, 2 masked interpreters randomly assessed both PET datasets for image quality (3-point scale) and for the presence of focal lesions with increased (18)F-fluoride uptake (maximum of 4 lesions). For each dataset (PET/CT vs. PET/MR), the diagnoses were defined using both PET and a...
The prognostic and diagnostic value of 18F-FDG PET/CT for assessment of symptomatic osteoarthritis
Nuclear medicine communications, 2018
The objective of this study was to assess the clinical significance of increased fluorine-18-fluorodeoxyglucose (F-FDG) uptake on PET/CT in joints for evaluation of symptomatic osteoarthritis (OA) and prediction of progression. In this prospective study, shoulder, hip, and knee joints were imaged in 65 patients undergoing routine F-FDG PET/CT imaging. Patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire to assess joint pain, stiffness, and physical function. Standardized uptake values (SUVs) were measured in hip, knee, acromioclavicular (AC), and glenohumeral (GH) joints. Scout PET/CT images were evaluated for OA using the Kellgren and Lawrence (K/L) system. Patients were followed-up for 5 years to determine the progression of OA on the basis of follow-up imaging or surgical intervention. SUV of knee (r=0.309, P=0.0003), hip (r=0.260, P=0.0027), AC (r=0.186, P=0.0313), and GH (r=0.191, P=0.0271) joints correlated with WOMAC over...
International Journal of Surgery, 2007
Total knee arthroplasty is successful in the treatment of degenerative, arthritic or injured joints. But the most important long term complication seems to be aseptic loosening. An inflammatory process at the bone/cement or bone/ prosthesis interface leads to a severe osteolysis. Although early diagnosis is very important the standard techniques often fail. [ 18 F]Fluoride ion positron emission tomography (F-PET) is an appropriate tracer paired with a modern method for the evaluation of increased bone metabolism at the bone/prosthesis interface. In this preliminary study we describe for the first time the value of F-PET in the early diagnosis of aseptic loosening.
Foot pain: specific indications for scintigraphy
British journal of rheumatology, 1998
Bone scintigraphy is requested as part of the investigation of foot pain, but its contribution to clinical management has not been comprehensively documented. Previously published data are limited; the most comprehensive series identified scintigraphic abnormalities in patients with primarily orthopaedic problems and a control group was not included (Maurice HD et al. J Bone Joint Surg 1987;69B:448 52). The aim of this study was to evaluate whether bone scintigraphy may be useful in different clinical circumstances indicated by referral request details. Regions of scintigraphic abnormality were scored and compared with clinical details drawn from case notes of 60 patients with foot pain. The commonest clinical indications for scans were: confirmation of the clinical suspicion of plantar fasciitis, documentation of the extent of inflammatory arthritis and location of focal pathology. A group of 30 asymptomatic, age- and sex-matched controls were also studied. In 14 out of 19 symptoma...
The British Journal of Radiology
Objective: Os acromiale (OA) is a failure of complete fusion of the acromial process. It is usually asymptomatic and discovered incidentally. OA can contribute to shoulder impingement symptoms and rotator cuff tears. 18 F Sodium Fluoride (NaF) Positron Emission Tomography-CT (PET-CT) is an emerging and highly sensitive modality for oncological skeletal staging, and can show a variety of non-malignant uptake. We have analysed the relationship between 18 F-NaF uptake in OA and associated symptoms of shoulder pain. Methods: Study population included 21 patients (mean age 60.2 ± 12 years; 13 females and 8 males) with OA who underwent PET-CT scan by injecting 2.22 MBq kg −1 of 18 F-NaF. The relationship between 18 F-NaF uptake and OA as a cause of pain was analysed. A 3-point grading system was used to evaluate uptake of 18 F-NaF. Results: In total 27 OA (12 symptomatic and 15 asymptomatic) were enrolled. All symptomatic OA showed focal increase tracer uptake of Grade 2, while asymptomatic OA did not have significant activity Grade 0 (n = 11) and Grade 1 (n = 4). Conclusion: 18 F-NaF PET-CT appears to be a useful adjunct in the assessment of symptomatic OA with its particular strength being its high negative predictive value. Advances in knowledge: 18 F-NaF PET-CT may be used as an ancillary tool for identifying symptomatic OA as a cause of shoulder pain in cases where other obvious causes of shoulder pain have been excluded.
Gulhane Medical Journal
Heel spur is exostosis of the calcaneus. Plantar fasciitis and heel spur constitute a very common cause of plantar pain, which may be managed with radiation therapy (RT). In this study, we assessed the radiotherapeutic management of refractory painful heel spur and plantar fasciitis. Methods: In this retrospective study, we report our single center experience with RT for refractory painful heel spur and plantar fasciitis management over a period of 45 years and describe patient and treatment characteristics. Results: Between 1974 and 2019, a total of 4904 patients received RT at our department using cobalt-60 teletherapy machine for the management of refractory painful heel spur and plantar fasciitis. Out of the total 4904 patients, 2012 patients (41%) were male and 2892 patients (59%) were female. The median age was 51 (range: 41-85) years. All patients had received previous therapies for refractory painful heel spur and plantar fasciitis before the management with RT. Total RT dose was 8 Gy delivered in 2 consecutive days with daily fractions of 4 Gy using 2 opposing anterior-posterior RT fields to both heels without bolus material. Treatment response was assessed 3 to 5 weeks after the completion of RT. Response to RT was complete in 3579 patients (73%), partial in 1188 patients (24.2%), and none in 137 patients (2.8%). No therapyrelated toxicity was observed in the whole series. Conclusion: RT for refractory painful heel spur and plantar fasciitis may offer effective palliation of pain and may be considered as a viable therapeutic option for selected patients exhausted with other treatment modalities.
Comparison of MRI and 18F-NaF PET/CT in patients with patellofemoral pain
Journal of Magnetic Resonance Imaging, 2012
Purpose: To determine whether bone metabolic activity corresponds to bone and cartilage damage in patients with patellofemoral pain. Materials and Methods: We acquired magnetic resonance imaging (MRI) and 18 F-NaF positron emission tomography (PET) / computed tomography (CT) scans of the knees of 22 subjects. We compared locations of increased tracer uptake on the 18 F-NaF PET images to bone marrow edema and cartilage damage visualized on MRI. Results: We found that increased bone activity on 18 F-NaF PET does not always correspond to structural damage in the bone or cartilage as seen on MRI. Conclusion: Our results suggest that 18 F-NaF PET/CT may provide additional information in patellofemoral pain patients compared to MRI.
British Journal of Radiology, 2018
Objective: Os acromiale (OA) is a failure of complete fusion of the acromial process. It is usually asymptomatic and discovered incidentally. OA can contribute to shoulder impingement symptoms and rotator cuff tears. 18 F Sodium Fluoride (NaF) Positron Emission Tomography-CT (PET-CT) is an emerging and highly sensitive modality for oncological skeletal staging, and can show a variety of non-malignant uptake. We have analysed the relationship between 18 F-NaF uptake in OA and associated symptoms of shoulder pain. Methods: Study population included 21 patients (mean age 60.2 ± 12 years; 13 females and 8 males) with OA who underwent PET-CT scan by injecting 2.22 MBq kg −1 of 18 F-NaF. The relationship between 18 F-NaF uptake and OA as a cause of pain was analysed. A 3-point grading system was used to evaluate uptake of 18 F-NaF. Results: In total 27 OA (12 symptomatic and 15 asymptomatic) were enrolled. All symptomatic OA showed focal increase tracer uptake of Grade 2, while asymptomatic OA did not have significant activity Grade 0 (n = 11) and Grade 1 (n = 4). Conclusion: 18 F-NaF PET-CT appears to be a useful adjunct in the assessment of symptomatic OA with its particular strength being its high negative predictive value. Advances in knowledge: 18 F-NaF PET-CT may be used as an ancillary tool for identifying symptomatic OA as a cause of shoulder pain in cases where other obvious causes of shoulder pain have been excluded.