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Nucl Med Commun. 2015 Jun;36(6):596-603. doi: 10.1097/MNM.0000000000000284.

Prediction of femoral head collapse in osteonecrosis using 18F-fluoride positron emission tomography.

Author information

1
Departments of aOrthopaedic Surgery bRadiology, Yokohama City University, Yokohama, Japan.

Abstract

OBJECTIVE:

We investigated the usefulness of (18)F-fluoride PET as a predictor of femoral head collapse in patients with osteonecrosis (ON) before radiographic changes occur.

PATIENTS AND METHODS:

Sixty-six hips of 42 patients diagnosed with ON of the femoral head were included in this study. We evaluated the relationship between the maximum standardized uptake value (SUV(max)) in (18)F-fluoride PET and the Ficat classification. We evaluated the relationship between SUV(max) and the presence of femoral head collapse on plain radiography at 12 months after (18)F-fluoride PET in 23 hips of 18 patients with Ficat classification stage 1 or 2. A receiver operating characteristic analysis was carried out to calculate the cut-off SUVmax for the prediction of femoral head collapse. We analyzed the relationship between SUV(max) and femoral head collapse on plain radiography in the 23 hips using a logistic regression model.

RESULTS:

SUV(max) increased according to the progression of the Ficat classification stage. The mean SUV(max) was 12.3±5.9 in the collapse group and 4.9±1.3 in the noncollapse group (P<0.01). The cut-off SUV(max) of 6.45 (sensitivity: 0.80, specificity: 0.92) was used for the prediction of femoral head collapse. In the univariate analysis, SUV(max), type classification, and ring sign were related significantly to femoral head collapse.

CONCLUSION:

We showed that the quantitative assessment of SUV(max) in (18)F-fluoride PET was useful to predict femoral head collapse in ON. (18)F-Fluoride PET might reflect accelerated bone metabolism because of microcollapse of the femoral head, which is undetectable on plain radiography.

PMID:
25714808
DOI:
10.1097/MNM.0000000000000284
[Indexed for MEDLINE]

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