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  • 1.
    Lundblad, Henrik
    et al.
    Karolinska Institutet, Sweden.
    Maguire Jr., Gerald Q.
    KTH, School of Information and Communication Technology (ICT), Communication Systems, CoS, Radio Systems Laboratory (RS Lab).
    Karlsson-Thur, Charlotte
    Karolinska Institutet, Sweden.
    Jonsson, Cathrine
    Karolinska University Hospital Solna, Sweden.
    Noz, Marilyn E.
    New York University, USA.
    Zeleznik, Michael P.
    University of Utah, USA.
    Jacobsson, Hans
    Karolinska Institutet, Sweden.
    Weidenhielm, Lars
    Karolinska Institutet, Sweden.
    Using PET/CT Bone Scan Dynamic Data to Evaluate Tibia Remodeling When a Taylor Spatial Frame Is Used: Short and Longer Term Differences2015In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, Vol. 2015, p. 1-11, article id 574705Article in journal (Refereed)
    Abstract [en]

    Eighteen consecutive patients, treated with a Taylor Spatial Frame for complex tibia conditions, gave their informed consentto undergo Na18F− PET/CT bone scans. We present a Patlak-like analysis utilizing an approximated blood time-activity curveeliminating the need for blood aliquots. Additionally, standardized uptake values (SUV) derived from dynamic acquisitions werecompared to this Patlak-like approach. Spherical volumes of interest (VOIs) were drawn to include broken bone, other (normal)bone, and muscle. The SUV𝑚(𝑡) (𝑚 = max, mean) and a series of slopes were computed as (SUV𝑚(𝑡𝑖) − SUV𝑚(𝑡𝑗))/(𝑡𝑖 − 𝑡𝑗), forpairs of time values 𝑡𝑖 and 𝑡𝑗. A Patlak-like analysis was performed for the same time values by computing ((VOI𝑝(𝑡𝑖)/VOI𝑒(𝑡𝑖)) −(VOI𝑝(𝑡𝑗)/VOI𝑒(𝑡𝑗)))/(𝑡𝑖−𝑡𝑗), where p = broken bone, other bone, andmuscle and e = expected activity in aVOI. Paired comparisonsbetween Patlak-like and SUV𝑚 slopes showed good agreement by both linear regression and correlation coefficient analysis(𝑟 = 84%, 𝑟𝑠 = 78%-SUVmax, 𝑟 = 92%, and 𝑟𝑠 = 91%-SUVmean), suggesting static scans could substitute for dynamic studies.Patlak-like slope differences of 0.1 min−1 or greater between examinations and SUVmax differences of ∼5 usually indicated goodremodeling progress, while negative Patlak-like slope differences of −0.06 min−1 usually indicated poor remodeling progress in thiscohort.

  • 2.
    Lundblad, Henrik
    et al.
    Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden .
    Maguire Jr., Gerald Q.
    KTH, School of Information and Communication Technology (ICT), Communication Systems, CoS, Radio Systems Laboratory (RS Lab).
    Olivecrona, Henrik
    Karolinska Institute.
    Jonsson, Cathrine
    Department of Medical Physics, Karolinska University Hospital, Stockholm, Sweden.
    Jacobsson, Hans
    Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden .
    Noz, Marilyn E.
    New York University, Department of Radiology.
    Zeleznik, Michael P.
    University of Utah.
    Weidenhielm, Lars
    Karolinska Institutet at Karolinska University Hospital Solna.
    Sundin, Anders
    Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden .
    Can Na18F PET/CT Be Used to Study Bone Remodeling in the Tibia When Patients Are Being Treated with a Taylor Spatial Frame?2014In: Scientific World Journal, E-ISSN 1537-744X, Vol. 2014, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Monitoring and quantifying bone remodeling are of interest, for example, in correction osteotomies, delayed fracture healing pseudarthrosis, bone lengthening, and other instances. Seven patients who had operations to attach an Ilizarov-derived Taylor Spatial Frame to the tibia gave informed consent. Each patient was examined by (NaF)-F-18 PET/CT twice, at approximately six weeks and three months after the operation. A validated software tool was used for the following processing steps. The first and second CT volumes were aligned in 3D and the respective PET volumes were aligned accordingly. In the first PET volume spherical volumes of interest (VOIs) were delineated for the crural fracture and normal bone and transferred to the second PET volume for SUVmax evaluation. This method potentially provides clinical insight into questions such as, when has the bone remodeling progressed well enough to safely remove the TSF? and when is intervention required, in a timelier manner than current methods? For example, in two patients who completed treatment, the SUVmax between the first and second PET/CT examination decreased by 42% and 13%, respectively. Further studies in a larger patient population are needed to verify these preliminary results by correlating regional (NaF)-F-18 PET measurements to clinical and radiological findings.

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