Assessment of bone synthetic activity in inflammatory lesions and syndesmophytes in patients with ankylosing spondylitis: the potential role of 18F-fluoride positron emission tomography-magnetic resonance imaging

作者：Lee S G; Kim I J^*; Kim K Y; Kim H Y; Pak K J; Kim S J; Park E K; Jeon Y K; Yang B Y; Kim G T

来源：Clinical and Experimental Rheumatology, 2015, 33(1): 90-97.

• ankylosing spondylitis
• positron emission tomography
• fluoride
• osteoblast

Objective
18F-fluoride uptake represents active osteoblastic bone synthesis. We assessed bone synthetic activity in inflammatory lesions and syndesmophytes in patients with ankylosing spondylitis (AS) using 18F-fluoride positron emission tomography-magnetic resonance imaging (PET-MRI, Philips Healthcare, Cleveland, OH, USA) and x-ray.
Methods
All images of 12 AS patients were recorded with the presence or absence of increased 18F-fluoride uptake lesions on PET, acute (type A) or advanced (type B) corner inflammatory lesions (CILs) on MRI, syndesmophytes on x-ray at the anterior vertebral corners. An increased 18F-fluoride uptake lesion was defined as an uptake which is greater than the uptake in the adjacent normal vertebral body. The association of a CIL or syndesmophyte with an increased 18F-fluoride uptake lesion was investigated by generalised linear latent mixed models analysis to adjust within-patient dependence for total numbers of vertebral corners.
Results
There were 67 type A CILs (12.1%), 37 type B CILs (6.7%) and 58 increased 18F-fluoride uptake lesion (10.4%) out of 552 vertebral corners and there were 57 syndesmophytes (19.8%) out of 288 vertebral corners. A type A CIL (OR=3.2, 95% CI= 1.6-6.5, p=0.001), type B CIL (OR=59.9, 95% CI=23.5-151.5, p<0.001) and syndesmpophyte (OR=21.8, 95% C1=5.5-85.2, p<0.001) were significantly associated with an increased 18F-fluoride uptake lesion.
Conclusion
Our data suggest that an inflammatory lesion as well as a syndesmophyte is associated with active bone synthesis assessed by 18F-fluoride uptake in the spine of AS patients. 18F-fluoride PET-MRI may have the potential for investigating the pathogenesis of structural damage in AS.

• 出版日期2015-2