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Toshiyuki Watanabe, Kaoru Takase-Minegishi, Atsushi Ihata, Yosuke Kunishita, Daiga Kishimoto, Reikou Kamiyama, Maasa Hama, Ryusuke Yoshimi, Yohei Kirino, Yukiko Asami, Akiko Suda, Shigeru Ohno, Ukihide Tateishi, Atsuhisa Ueda, Mitsuhiro Takeno, Yoshiaki Ishigatsubo, 18F-FDG and 18F-NaF PET/CT demonstrate coupling of inflammation and accelerated bone turnover in rheumatoid arthritis, Modern Rheumatology, Volume 26, Issue 2, 3 March 2016, Pages 180–187, https://doi.org/10.3109/14397595.2015.1069458
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Abstract
Objective. To compare the findings in rheumatoid arthritis (RA)-affected joints between 18F-fluorodeoxyglucose (FDG) and 18F-fluoride (NaF) positron emission tomography (PET)/computed tomography (CT).
Methods. We enrolled twelve RA patients who started a new biologic agent (naïve 9 and switch 3). At entry, both hands were examined by 18F-FDG PET/CT, 18F-NaF PET/CT, and X-ray. Intensity of PET signals was determined by standardized uptake value max (SUVmax) in metacarpophalangeal (MCP), proximal interphalangeal (PIP), and ulnar, medial, and radial regions of the wrists. Hand X-rays were evaluated according to the Genant-modified Sharp score at baseline and 6 months.
Results. Both 18F-FDG and 18F-NaF accumulated in RA-affected joints. The SUVmax of 18F-FDG correlated with that of 18F-NaF in individual joints (r = 0.65), though detail distribution was different between two tracers. 18F-NaF and 18F-FDG signals were mainly located in the bone and the surrounding soft tissues, respectively. The sum of SUVmax of 18F-NaF correlated with disease activity score in 28 joint (DAS28), modified health assessment questionnaire (MHAQ), and radiographic progression. 18F-FDG and 18F-NaF signals were associated with the presence of erosions, particularly progressive ones.
Conclusion. Our data show that both 18F-FDG and 18F-NaF PET signals were associated with RA-affected joints, especially those with ongoing erosive changes.