Abstract
1192
Objectives: Degenerative osseous changes of the body joints are one of the sequelae in Rheumatoid Arthritis (RA) that is associated with inflammation of the synovial tissue. Affection of the temporomandibular joint (TMJ) may have significant impact on patients’ lifestyle as it may cause joint dysfunction and ankylosis with bite and closing difficulties. Structural imaging techniques have been used to detect osseous changes in TMJ, but little effort has been done to evaluate the potential of molecular imagining in TMJ disorders. The aim of this study was to investigate the role of 18F-sodium fluoride (NaF) in PET/CT imaging of the TMJ in RA patients compared to healthy control subjects.
Methods: Eighteen patients diagnosed with RA (mean age 55±12.1years,4 females and 14 male) were included in this study as the test group and 18 healthy control subjects (mean age 54±13.1) were selected from the CAMONA clinical trial with matching age and gender. PET/CT images were acquired 90 minutes post intravenous administration of NaF (2.2 MBq/kg). OsirX® MD v.9.0 software (Pixmeo SARL, Bernex, Switzerland) was used for image analysis. Clinical data including Disease Activity Score of C-reactive protein (DAS28-CPR) and erythrocyte sedimentation rate (DAS28-ESR) were obtained for RA patients. A 3D ball tool of 1.5 cm was used to assign the regions of interest (ROIs), where the head of the mandibular condyle was located at the center of ROI including the osseous compartment of the joint extending inferiorly to the neck of the condyle (Figure1). The average SUVmean of the right and the left TMJ was determined and the target to background ratio (TBR) was calculated for each subject by dividing the average TMJ SUVmean by the NaF SUVmean in the superior vena cava. For statistical analysis, the student’s t-test was used to compare average SUVmean and TBR in RA patients and control subjects, and regression analysis was used to examine the potential association of these quantities with DAS28-CPR and DAS28-ESR.
Results: The NaF average SUVmean was significantly higher in RA patients than healthy control subjects: 2.4±0.8 vs. 1.9±0.4, p=0.02. Similarly, the TMJ TBRmean in RA patients was also higher in RA patients than in healthy controls (4.2±2.1 vs. 2.7±0.9, p=0.01) (Figure 2 a,b). A significant positive correlation was found between TBRmean and DAS28-CPR (r=0.49, p=0.03), while an insignificant one was observed between DAS28-ESR (r=0.37, p=0.12) (Figure 2 c,d).
Conclusions: NaF-PET/CT scan appears to be a valuable imaging approach in evaluating the metabolic activity in osseous structures of the TMJ in RA patients. The degree of NaF uptake in the TMJ correlated with biochemical parameters of disease severity based on DAS28-CPR and DAS28-ESR scores. <!--EndFragment-->
In this issue
Jump to section
Related Articles
Cited By...
- No citing articles found.