18F-Sodium fluoride PET-CT visualizes disease activity in chronic nonbacterial osteitis in adults

• Published in: JBMR plus 2024-02, Vol.8 (2), p.ziad007-ziad007
• Main Authors: Leerling, Anne T, Smit, Frits, Spӓth, Zita, Cañete, Ana Navas, de Geus-Oei, Lioe-Fee, van de Burgt, Alina, Dekkers, Olaf M, van der Bruggen, Wouter, Appelman-Dijkstra, Natasha M, Vriens, Dennis, Winter, Elizabeth M
• Format: Article
• Language: English
• ISSN: 2473-4039; 2473-4039
• DOI: 10.1093/jbmrpl/ziad007

Chronic nonbacterial osteitis (CNO) is a rare disease spectrum, which lacks biomarkers for disease activity. Sodium fluoride-18 positron emission tomography/computed tomography ([18F]NaF-PET/CT) is a sensitive imaging tool for bone diseases and yields quantitative data on bone turnover. We evaluated the capacities of [18F]NaF-PET/CT to provide structural and functional assessment in adult CNO. A coss-sectional study was performed including 43 adult patients with CNO and 16 controls (patients referred for suspected, but not diagnosed with CNO) who underwent [18F]NaF-PET/CT at our expert clinic. Structural features were compared between patients and controls, and maximal standardized uptake values (SUVmax [g/mL]) were calculated for bone lesions, soft tissue/joint lesions, and reference bone. SUVmax was correlated with clinical disease activity in patients. Structural assessment revealed manubrial and costal sclerosis/hyperostosis and calcification of the costoclavicular ligament as typical features associated with CNO. SUVmax of CNO lesions was higher compared with in-patient reference bone (mean paired difference: 11.4; 95% CI: 9.4–13.5; p