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Kogan F, Yoon D, Teeter MG, Chaudhari AJ, Hales L, Barbieri M, Gold GE, Vainberg Y, Goyal A, Watkins L. Multimodal positron emission tomography (PET) imaging in non-oncologic musculoskeletal radiology. Skeletal Radiol 2024; 53:1833-1846. [PMID: 38492029 DOI: 10.1007/s00256-024-04640-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/18/2024]
Abstract
Musculoskeletal (MSK) disorders are associated with large impacts on patient's pain and quality of life. Conventional morphological imaging of tissue structure is limited in its ability to detect pain generators, early MSK disease, and rapidly assess treatment efficacy. Positron emission tomography (PET), which offers unique capabilities to evaluate molecular and metabolic processes, can provide novel information about early pathophysiologic changes that occur before structural or even microstructural changes can be detected. This sensitivity not only makes it a powerful tool for detection and characterization of disease, but also a tool able to rapidly assess the efficacy of therapies. These benefits have garnered more attention to PET imaging of MSK disorders in recent years. In this narrative review, we discuss several applications of multimodal PET imaging in non-oncologic MSK diseases including arthritis, osteoporosis, and sources of pain and inflammation. We also describe technical considerations and recent advancements in technology and radiotracers as well as areas of emerging interest for future applications of multimodal PET imaging of MSK conditions. Overall, we present evidence that the incorporation of PET through multimodal imaging offers an exciting addition to the field of MSK radiology and will likely prove valuable in the transition to an era of precision medicine.
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Affiliation(s)
- Feliks Kogan
- Department of Radiology, Stanford University, Stanford, CA, USA.
| | - Daehyun Yoon
- Department of Radiology, University of California-San Francisco, San Francisco, CA, USA
| | - Matthew G Teeter
- Department of Medical Biophysics, Western University, London, ON, Canada
| | | | - Laurel Hales
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Marco Barbieri
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Yael Vainberg
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Ananya Goyal
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Lauren Watkins
- Department of Radiology, Stanford University, Stanford, CA, USA
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2
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Shpigelman A, Shouval A, Koder I, Keret S, Slobodin G. Facet joint involvement in the inflammatory rheumatic disease. Joint Bone Spine 2024; 91:105674. [PMID: 38101697 DOI: 10.1016/j.jbspin.2023.105674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/12/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND The involvement of facet joints (FJ) in patients with inflammatory rheumatic disorders remains underexplored. This review aims to look at FJ disease from a rheumatologist's perspective, with the emphasis given to the clinical presentations and patterns of FJ engagement in axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), rheumatoid arthritis (RA), and crystal-related arthropathies, and discussion of challenges in studying FJ in rheumatic disease. METHODS A systematic PubMed search using the pertinent keywords was performed, relevant articles extracted, and the acquired data critically assessed, interpreted, and organized according to the authors' experience and judgment. RESULTS FJ involvement is common in patients with radiographic axSpA, occurs throughout the spine, but is more frequently seen in the thoracic segment. The existing data suggests that the FJ are primarily affected by the disease process, while altered spine biomechanics due to the presence of syndesmophytes at the same vertebral level contributes to the FJ fusion. Predominant involvement of FJ of the cervical spinal segment has been suggested in PsA; however, prevalence and clinical significance of FJ involvement in PsA is still markedly underexplored. RA-related FJ disease of the cervical spine in patients with poorly controlled RA is not uncommon and can be related to significant morbidity, while the burden of FJ involvement in the thoracic and lumbar spinal segments in RA is also underexplored. FJ disease is possible in the course of crystal-related arthropathies, but the high level of suspicion is a prerequisite for the timely diagnosis. CONCLUSIONS The involvement of FJ in the course of inflammatory rheumatic disease is not uncommon. Prospective studies are needed to understand the epidemiology and significance of FJ disease in inflammatory rheumatic conditions.
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Affiliation(s)
- Arsen Shpigelman
- Spine Unit, Department of Orthopedic Surgery, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Aniela Shouval
- Rheumatology Unit, Bnai Zion Medical Center, Haifa, Israel
| | - Ilai Koder
- Spine Unit, Department of Orthopedic Surgery, Lady Davis Carmel Medical Center, Haifa, Israel
| | - Shiri Keret
- Rheumatology Unit, Bnai Zion Medical Center, Haifa, Israel
| | - Gleb Slobodin
- Rheumatology Unit, Bnai Zion Medical Center, Haifa, Israel.
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3
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Lehman VT, Tiegs-Heiden CA, Broski SM. Beyond Anatomy: Fat-Suppressed MR and Molecular Imaging of Spinal Pain Generators. Radiol Clin North Am 2024; 62:247-261. [PMID: 38272618 DOI: 10.1016/j.rcl.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Spine pain is highly prevalent and costly, but evaluation with clinical features and anatomic imaging remain limited. Fat-suppressed MR imaging and molecular imaging (MI) may help identify inflammatory, lesional, and malignant causes. Numerous MI agents are available, each with advantages and disadvantages. Herein, FDG PET, prostate-specific membrane antigen (PSMA), bone radiotracers, and others are highlighted. No specific pain MI agents have been identified, but mechanisms of key agents are shown in video format, and the mechanism of PSMA as a theranostic agent is displayed. A multidisciplinary approach is needed to master this topic.
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Affiliation(s)
- Vance T Lehman
- Department of Radiology, Mayo Clinic, 200 1st Street SouthWest, Rochester, MN 55905, USA.
| | | | - Stephen M Broski
- Department of Radiology, Mayo Clinic, 200 1st Street SouthWest, Rochester, MN 55905, USA
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4
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PET Imaging in Osteoarthritis. PET Clin 2023; 18:21-29. [DOI: 10.1016/j.cpet.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Koa B, Raynor WY, Park PSU, Borja AJ, Singhal S, Kuang A, Zhang V, Werner TJ, Alavi A, Revheim ME. Feasibility of Global Assessment of Bone Metastases in Prostate Cancer with 18F-Sodium Fluoride-PET/Computed Tomography. PET Clin 2022; 17:631-640. [DOI: 10.1016/j.cpet.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Jena A, Goyal N, Rana P, Taneja S, Vaish A, Botchu R, Vaishya R. Differential 18F-NaF uptake in various compartments in knee osteoarthritis: an observational study using PET/MRI. Clin Radiol 2022; 77:613-620. [PMID: 35589431 DOI: 10.1016/j.crad.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/11/2022] [Indexed: 11/03/2022]
Abstract
AIM To investigate if the pattern of fluorine-18-labelled sodium fluoride (18F-NaF) uptake on integrated positron-emission tomography (PET)/magnetic resonance imaging (MRI) of bone marrow lesions (BML) and osteophytes differs between different knee compartments. MATERIALS AND METHODS Sixteen patients with no prior history of knee injury with or without pain were recruited for the study. The images of both knees were acquired on simultaneous PET/MRI. The acquisition was done after 45 minutes of intravenous injection of 18F-NaF 185-370 MBq (5-10 mCi) for 40 minutes. Each knee was divided into eight compartments patella, trochlea, medial central femur, lateral central femur, medial posterior femur, lateral posterior femur, medial tibia, lateral tibia, and cruciate ligament insertion specifically for BML. BML and osteophytes were scored using MRI Osteoarthritis Knee Score (MOAKS) criteria and their corresponding maximum standardised uptake values (SUVmax) recorded. RESULTS BML and osteophytes both showed statistically significant differences among knee compartments, i.e., p-value <0.000 and < 0.043 respectively. SUVmax for BML and osteophytes was greatest in the medial tibia. CONCLUSION 18F-NaF PET/MRI showed that BML and osteophytes had differential uptake values due to bone remodelling amongst the various knee compartments and this may help to design disease-modifying osteoarthritis drugs in the future.
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Affiliation(s)
- A Jena
- PET Suite (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, New Delhi, India
| | - N Goyal
- Department of Radiodiagnosis and Imaging, Indraprastha Apollo Hospitals, New Delhi, India
| | - P Rana
- PET Suite (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, New Delhi, India; Apollo Hospitals Education & Research Foundation, Indraprastha Apollo Hospitals, New Delhi, India
| | - S Taneja
- PET Suite (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, New Delhi, India
| | - A Vaish
- Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, India
| | - R Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK.
| | - R Vaishya
- Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, India
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Spirig JM, Hüllner M, Cornaz F, Betz M, Wanivenhaus F, Hofbauer M, Johayem A, Kaufmann PA, Farshad M. [18F]-sodium fluoride PET/MR for painful lumbar facet joint degeneration - a randomized controlled clinical trial. Spine J 2022; 22:769-775. [PMID: 34848344 DOI: 10.1016/j.spinee.2021.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT [18F]-sodium fluoride (NaF) PET/MR is a modern diagnostic modality for imaging increased bone turnover. Its merits in detecting painful facet joint osteoarthritis in patients with lumbar back pain are unknown. PURPOSE To perform a prospective randomized controlled study investigating [18F]-NaF PET/MR for detecting painful facet joints in comparison to the standard of care (SOC), including clinical examination and conventional MRI. STUDY DESIGN/SETTING Randomized controlled clinical study. PATIENT SAMPLE Thirty-nine patients. OUTCOME MEASURES Visual analog pain scale (VAS) before and at several time points after facet joint infiltration. METHODS Patients with low back pain and suspected facet joint osteoarthritis underwent lumbar [18F]-NaF PET/MR, besides conventional MRI and clinical examination. After randomization, they either received local anesthetics/ corticosteroid infiltration of facet joints as defined by clinical examination and conventional MRI (SOC), or according to the hot spots on PET/MR. VAS was documented at 15 minutes, 1 day, 1 week and 1 month after infiltration. Thirty-nine patients underwent PET/MR before the study was stopped due to new Good Manufacturing Practice requirement and new regulations by radiation protection authorities limiting staff radiation exposure during the production of this radiotracer. RESULTS Significant pain reduction compared to baseline was shown at every timepoint in both groups, except at 1 month after infiltration in the SOC group. Pain levels did not differ between SOC (n=17) and PET/MR patients (n=12) before infiltration and at 15 minutes, 1 day, 1 week and 1 month after infiltration. No significant correlation was detected between the sum of the PET/MR activity and the initial pain scores or relative reduction of pain after 15 minutes. The constructed study groups of patients with infiltration of all facet joints being PET/MR-positive (n=18) had significantly less pain after 1 months than patients with infiltration in PET/MR-negative facet joints (n=11) (VAS: 4 [0, 9] vs. 7 [2, 10], p=.046). CONCLUSIONS There is no correlation of pain to NaF activity nor a relevant superiority of [18F]-NaF PET/MR for identification of painful facet joints compared to the standard of care.
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Affiliation(s)
- José Miguel Spirig
- Spine Division, Balgrist University Hospital, University of Zurich, Forchstrasse 340, Zurich 8008, Switzerland.
| | - Martin Hüllner
- Department of Nuclear Medicine, University Hospital Zürich, University of Zurich, Rämistrasse 100, Zurich 8091, Switzerland
| | - Frédéric Cornaz
- Spine Division, Balgrist University Hospital, University of Zurich, Forchstrasse 340, Zurich 8008, Switzerland
| | - Michael Betz
- Spine Division, Balgrist University Hospital, University of Zurich, Forchstrasse 340, Zurich 8008, Switzerland
| | - Florian Wanivenhaus
- Spine Division, Balgrist University Hospital, University of Zurich, Forchstrasse 340, Zurich 8008, Switzerland
| | - Marlena Hofbauer
- Department of Nuclear Medicine, University Hospital Zürich, University of Zurich, Rämistrasse 100, Zurich 8091, Switzerland
| | - Anass Johayem
- Department of Nuclear Medicine, University Hospital Zürich, University of Zurich, Rämistrasse 100, Zurich 8091, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, University Hospital Zürich, University of Zurich, Rämistrasse 100, Zurich 8091, Switzerland
| | - Mazda Farshad
- Spine Division, Balgrist University Hospital, University of Zurich, Forchstrasse 340, Zurich 8008, Switzerland
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8
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Piri R, Nøddeskou-Fink AH, Gerke O, Larsson M, Edenbrandt L, Enqvist O, Høilund-Carlsen PF, Stochkendahl MJ. PET/CT imaging of spinal inflammation and microcalcification in patients with low back pain: A pilot study on the quantification by artificial intelligence-based segmentation. Clin Physiol Funct Imaging 2022; 42:225-232. [PMID: 35319166 PMCID: PMC9322590 DOI: 10.1111/cpf.12751] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/11/2022] [Indexed: 12/29/2022]
Abstract
Background Current imaging modalities are often incapable of identifying nociceptive sources of low back pain (LBP). We aimed to characterize these by means of positron emission tomography/computed tomography (PET/CT) of the lumbar spine region applying tracers 18F‐fluorodeoxyglucose (FDG) and 18F‐sodium fluoride (NaF) targeting inflammation and active microcalcification, respectively. Methods Using artificial intelligence (AI)‐based quantification, we compared PET findings in two sex‐ and age‐matched groups, a case group of seven males and five females, mean age 45 ± 14 years, with ongoing LBP and a similar control group of 12 pain‐free individuals. PET/CT scans were segmented into three distinct volumes of interest (VOIs): lumbar vertebral bodies, facet joints and intervertebral discs. Maximum, mean and total standardized uptake values (SUVmax, SUVmean and SUVtotal) for FDG and NaF uptake in the 3 VOIs were measured and compared between groups. Holm–Bonferroni correction was applied to adjust for multiple testing. Results FDG uptake was slightly higher in most locations of the LBP group including higher SUVmean in the intervertebral discs (0.96 ± 0.34 vs. 0.69 ± 0.15). All NaF uptake values were higher in cases, including higher SUVmax in the intervertebral discs (11.63 ± 3.29 vs. 9.45 ± 1.32) and facet joints (14.98 ± 6.55 vs. 10.60 ± 2.97). Conclusion Observed intergroup differences suggest acute inflammation and microcalcification as possible nociceptive causes of LBP. AI‐based quantification of relevant lumbar VOIs in PET/CT scans of LBP patients and controls appears to be feasible. These promising, early findings warrant further investigation and confirmation.
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Affiliation(s)
- Reza Piri
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Lars Edenbrandt
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Physiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olof Enqvist
- Eigenvision AB, Malmö, Sweden.,Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Poul-Flemming Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mette J Stochkendahl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense, Denmark
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9
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Tram NK, Chou TH, Patel S, Ettefagh LN, Go MR, Atway SA, Stacy MR. Novel Application of 18F-NaF PET/CT Imaging for Evaluation of Active Bone Remodeling in Diabetic Patients With Charcot Neuropathy: A Proof-of-Concept Report. Front Med (Lausanne) 2022; 9:795925. [PMID: 35252240 PMCID: PMC8896741 DOI: 10.3389/fmed.2022.795925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
Charcot neuropathic osteoarthropathy (CN) is a serious and potentially limb-threatening complication for patients with diabetes mellitus and peripheral arterial disease. In recent decades, nuclear medicine-based approaches have been used for non-invasive detection of CN; however, to date, a positron emission tomography (PET) radionuclide specifically focused on targeted imaging of active bone remodeling has not been explored or validated for patients with CN. The radionuclide 18F-sodium fluoride (NaF) has historically been used as a bone imaging probe due to its high sensitivity for targeting hydroxyapatite and bone turnover, but has not been applied in the context of CN. Therefore, the present study focused on novel application of 18F-NaF PET/computed tomography (CT) imaging to three clinical cases of CN to evaluate active bone remodeling at various time courses of CN. PET/CT imaging in all 3 cases demonstrated focal uptake of 18F-NaF in the bones of the feet afflicted with CN, with bone retention of 18F-NaF persisting for up to 5 years following surgical reconstruction of the foot in two cases. On a group level, 18F-NaF bone uptake in the CN foot was significantly higher compared to the healthy, non-CN foot (p = 0.039). 18F-NaF PET/CT imaging may provide a non-invasive tool for monitoring active bone remodeling in the setting of CN, thereby offering novel opportunities for tracking disease progression and improving treatment and surgical intervention.
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Affiliation(s)
- Nguyen K. Tram
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Ting-Heng Chou
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Surina Patel
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Laila N. Ettefagh
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Michael R. Go
- Division of Vascular Diseases and Surgery, Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Said A. Atway
- Department of Orthopaedics, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Mitchel R. Stacy
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
- Division of Vascular Diseases and Surgery, Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, United States
- *Correspondence: Mitchel R. Stacy
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10
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Dillon WP. 50th anniversary of computed tomography: past and future applications in clinical neuroscience. J Med Imaging (Bellingham) 2021; 8:052112. [PMID: 34676278 PMCID: PMC8523063 DOI: 10.1117/1.jmi.8.5.052112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/27/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose: It has been 50 years since computed tomography was introduced to the worldwide neurologic medical and surgical community. In that time, tremendous advances in computer software and hardware, as well as creative changes in computerized tomographic (CT) hardware and tube technology, have dramatically improved the temporal and spatial resolution of CT. In this paper, I address what I feel are some of the most important impacts of CT in the field of clinical neuroscience over the last 50 years, as well as potential applications of CT that are on the horizon. Approach: I have recounted from literature, colleagues, and personal recollection the historical impact of CT on neuroradiology practice and what appear to be near-term future applications. Conclusions: Therapeutic applications beyond diagnosis, such as image-guided procedures, radiation, and surgical planning, and development of the field of theranostics have emerged and further increased the need for faster and more precise CT imaging. The integration of machine learning into the acquisition chain and radiologist tool kit has great implications for standardization, analysis, and diagnosis worldwide.
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Affiliation(s)
- William P Dillon
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, California, United States
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11
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Raynor WY, Borja AJ, Hancin EC, Werner TJ, Alavi A, Revheim ME. Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET. PET Clin 2021; 16:295-311. [PMID: 33589389 DOI: 10.1016/j.cpet.2020.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PET imaging with 18F-sodium fluoride (NaF), combined with computed tomography or magnetic resonance, is a sensitive method of assessing bone turnover. Although NaF-PET is gaining popularity in detecting prostate cancer metastases to bone marrow, osseous changes represent secondary effects of cancer cell growth. PET tracers more appropriate for assessing prostate cancer metastases directly portray malignant activity and include 18F-fluciclovine and prostatic specific membrane antigen ligands. Recent studies investigating NaF-PET suggest utility in the assessment of benign musculoskeletal disorders. Emerging applications in assessing traumatic injuries, joint disease, back pain, orthopedic complications, and metabolic bone disease are discussed.
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Affiliation(s)
- William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Drexel University College of Medicine, 2900 West Queen Lane, Philadelphia, PA 19129, USA
| | - Austin J Borja
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Emily C Hancin
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, Philadelphia, PA 19140, USA
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Mona-Elisabeth Revheim
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Division of Radiology and Nuclear Medicine, Oslo University Hospital, Sognsvannsveien 20, Oslo 0372, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, Oslo 0315, Norway.
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12
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Identifying Musculoskeletal Pain Generators Using Molecular Imaging. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00076-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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13
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Yoon D, Kogan F, Gold GE, Biswal S. Identifying Musculoskeletal Pain Generators Using Clinical PET. Semin Musculoskelet Radiol 2020; 24:441-450. [DOI: 10.1055/s-0040-1713607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractIdentifying the source of a person's pain is a significant clinical challenge because the physical sensation of pain is believed to be subjective and difficult to quantify. The experience of pain is not only modulated by the individual's threshold to painful stimuli but also a product of the person's affective contributions, such as fear, anxiety, and previous experiences. Perhaps then to quantify pain is to examine the degree of nociception and pro-nociceptive inflammation, that is, the extent of cellular, chemical, and molecular changes that occur in pain-generating processes. Measuring changes in the local density of receptors, ion channels, mediators, and inflammatory/immune cells that are involved in the painful phenotype using targeted, highly sensitive, and specific positron emission tomography (PET) radiotracers is therefore a promising approach toward objectively identifying peripheral pain generators. Although several preclinical radiotracer candidates are being developed, a growing number of ongoing clinical PET imaging approaches can measure the degree of target concentration and thus serve as a readout for sites of pain generation. Further, when PET is combined with the spatial and contrast resolution afforded by magnetic resonance imaging, nuclear medicine physicians and radiologists can potentially identify pain drivers with greater accuracy and confidence. Clinical PET imaging approaches with fluorine-18 fluorodeoxyglucose, fluorine-18 sodium fluoride, and sigma-1 receptor PET radioligand and translocator protein radioligands to isolate the source of pain are described here.
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Affiliation(s)
- Daehyun Yoon
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Feliks Kogan
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Garry E. Gold
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Sandip Biswal
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
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14
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Ma D, Li Y, Xiao W, Peng L, Wang L, Liao Z, Hu L. Achyranthes bidentata extract protects chondrocytes functions through suppressing glycolysis and apoptosis via MAPK/AKT signaling axis. Am J Transl Res 2020; 12:142-152. [PMID: 32051743 PMCID: PMC7013231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Osteoarthritis (OA) is considered to be a joint-associated disorder and one of leading reasons for disability, however, potential mechanism has never been clarified. The purpose of this research was to evaluate protective-effects of Achyranthes Bidentata extracts (ABE) on chondrocytes function in osteoarthritis. We performed a systematic investigation of transcriptional and proteomic landscapes to identify the underlying mechanisms behind effects of ABE on chondrocytic functions. OA animal models were generated in the present research. Chondrocytes were isolated and cultured, and then prepared for GeneChip analysis. Two-dimensional gel electrophoresis and LC-MS/MS analysis were conducted to analyze samples. Quantitative real-time PCR (qRT-PCR) and western blotting were used to evaluate expression of protein kinase B (AKT), β-tubulin and β-action. Apoptosis and glycolysis pathway were significantly compromised in chondrocytes with ABE stimulation as revealed by both transcriptional and proteomic data. Consistently, ABE suppressed chondrocytes apoptosis and glycolytic activity in vitro through modulating multiple genes, such as Plk2, Casp1/12 and Cers1 as well as Pkm2, Eno1/3 and Pgk2. Mechanically, ABE activated MAPK signaling pathway and suppressed AKT signaling pathway, therefore, reducing the glycolysis to provide survival benefits. We extended our analysis by verifying insulin-like growth factor 1 (IGF-1) and MAP kinase 1 (MEK1) in chondrocytes function. Depletion of either IGF-1 or MEK1 impaired AKT expression and phosphorylation, leading to the enhanced chondrocyte apoptosis and reduced cell proliferation. In conclusion, our study provided systematic view and molecular basis for ABE to serve as potential intervention of OA via suppressing AKT signaling.
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Affiliation(s)
- Dujun Ma
- Shenzhen Traditional Chinese Medicine HospitalShenzhen 518033, China
| | - Yuan Li
- The Second People’s Hospital of Futian District ShenzhenShenzhen 518000, China
| | - Wei Xiao
- Shenzhen Traditional Chinese Medicine HospitalShenzhen 518033, China
| | - Liping Peng
- Shenzhen Traditional Chinese Medicine HospitalShenzhen 518033, China
| | - Lixin Wang
- Shenzhen Traditional Chinese Medicine HospitalShenzhen 518033, China
| | - Zhouwei Liao
- Shenzhen Traditional Chinese Medicine HospitalShenzhen 518033, China
| | - Liekui Hu
- The Fourth Clinical Medical College of Guangzhou University of Chinese MedicineShenzhen 518033, China
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15
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Yolcu YU, Lehman VT, Bhatti AUR, Goyal A, Alvi MA, Bydon M. Use of Hybrid Imaging Techniques in Diagnosis of Facet Joint Arthropathy: A Narrative Review of Three Modalities. World Neurosurg 2019; 134:201-210. [PMID: 31655232 DOI: 10.1016/j.wneu.2019.10.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022]
Abstract
Facet joint osteoarthritis/arthropathy of the spine is a common cause of back and neck pain that frequently overlaps clinically with other diseases of the spine. Because of the possible overlap, it is crucial to have an accurate diagnostic strategy, especially when determining the management approach. Various strategies have been suggested and adopted, with several these still being used in clinics. Over the years, because of the disadvantages of single-modality imaging methods (computed tomography, magnetic resonance imaging, single-photon emission computed tomography), the interest in radiologic examination started to move toward hybrid imaging techniques. Although the data are mixed, many initial studies have shown promise. However, there are relatively few data with comparative medial branch blocks, and further investigation is needed. Given the advantages and disadvantages of these new techniques, the imaging results have to be interpreted within clinical context and with consideration of the current state of knowledge in the decision-making process.
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Affiliation(s)
- Yagiz Ugur Yolcu
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Vance T Lehman
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Atiq Ur Rehman Bhatti
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Anshit Goyal
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohammed Ali Alvi
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohamad Bydon
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
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16
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Clinical Nononcologic Applications of PET/CT and PET/MRI in Musculoskeletal, Orthopedic, and Rheumatologic Imaging. AJR Am J Roentgenol 2019; 210:W245-W263. [PMID: 29787313 DOI: 10.2214/ajr.17.18523] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE With improvements in PET/CT and PET/MRI over the last decade, as well as increased understanding of the pathophysiology of musculoskeletal diseases, there is an emerging potential for PET as a primary or complementary modality in the management of rheumatologic and orthopedic conditions. CONCLUSION We discuss the role of PET/CT and PET/MRI in nononcologic musculoskeletal disorders, including inflammatory and infectious conditions and postoperative complications. There is great potential for an increased role for PET to serve as a primary or complementary modality in the management of orthopedic and rheumatologic disorders.
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17
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Rathore B, Kagali R, Weiss F. Positron Emission Tomography (PET) Scans. Pain 2019. [DOI: 10.1007/978-3-319-99124-5_45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Jenkins NW, Talbott JF, Shah V, Pandit P, Seo Y, Dillon WP, Majumdar S. [ 18F]-Sodium Fluoride PET MR-Based Localization and Quantification of Bone Turnover as a Biomarker for Facet Joint-Induced Disability. AJNR Am J Neuroradiol 2017; 38:2028-2031. [PMID: 28860213 DOI: 10.3174/ajnr.a5348] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/06/2017] [Indexed: 11/07/2022]
Abstract
Our aim was to prospectively evaluate the relationship between low back pain-related disability and quantitative measures from [18F]-sodium fluoride ([18F]-NaF) MR imaging. Six patients with facetogenic low back pain underwent dynamic [18F]-NaF PET/MR imaging. PET metrics were correlated with clinical measures and MR imaging grading of lumbar facet arthropathy. A significant positive correlation was observed between maximum facet joint uptake rate and clinical disability (P < .05). These data suggest that dynamic [18F]-NaF PET may serve as a useful biomarker for facetogenic disability.
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Affiliation(s)
- N W Jenkins
- From the Department of Radiology and Biomedical Imaging (N.W.J., J.F.T., V.S., P.P., Y.S., W.P.D., S.M.), University of California, San Francisco, San Francisco, California
| | - J F Talbott
- From the Department of Radiology and Biomedical Imaging (N.W.J., J.F.T., V.S., P.P., Y.S., W.P.D., S.M.), University of California, San Francisco, San Francisco, California .,Department of Radiology and Biomedical Imaging (J.F.T.), Zuckerberg San Francisco General Hospital, San Francisco, California
| | - V Shah
- From the Department of Radiology and Biomedical Imaging (N.W.J., J.F.T., V.S., P.P., Y.S., W.P.D., S.M.), University of California, San Francisco, San Francisco, California
| | - P Pandit
- From the Department of Radiology and Biomedical Imaging (N.W.J., J.F.T., V.S., P.P., Y.S., W.P.D., S.M.), University of California, San Francisco, San Francisco, California
| | - Y Seo
- From the Department of Radiology and Biomedical Imaging (N.W.J., J.F.T., V.S., P.P., Y.S., W.P.D., S.M.), University of California, San Francisco, San Francisco, California
| | - W P Dillon
- From the Department of Radiology and Biomedical Imaging (N.W.J., J.F.T., V.S., P.P., Y.S., W.P.D., S.M.), University of California, San Francisco, San Francisco, California
| | - S Majumdar
- From the Department of Radiology and Biomedical Imaging (N.W.J., J.F.T., V.S., P.P., Y.S., W.P.D., S.M.), University of California, San Francisco, San Francisco, California
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