Comparison of six quantitative methods for the measurement of bone turnover at the hip and lumbar spine using F-18-fluoride PET-CT

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Aim The aim of this study was to evaluate the relationship between different quantification methods used for the measurement of bone plasma clearance (K-i) using F-18-PET at the hip and lumbar spine.

Methods Twelve healthy postmenopausal women aged 52-71 years were recruited. Each participant underwent 60-min dynamic F-18-PET scans at the lumbar spine and hip on two separate occasions with an injected activity of 90 and 180 MBq, respectively. Image-derived input functions were obtained at the aorta from the lumbar spine scans. K-i was evaluated using a three-compartment four-parameter model (Ki-4k), three-compartment three-parameter model (Ki-3k), Patlak analysis (Ki-Pat), spectral analysis (Ki-Spec) and deconvolution (Ki-Decon). Standardized uptake values (SUVs) were also measured.

Results The Pearson correlation between Ki-4k and Ki-3k, Ki-Pat, Ki-Spec, Ki-Decon and SUV were 0.91, 0.97, 0.94, 0.95 and 0.93, respectively, with a significance of P less than 0.0001. The differences between the correlations measured using Fisher's Z-test were not significant (P>0.05). Bland-Altman analysis showed that the limits of agreement for K-i measured as the SD of the differences were 0.0082 (25.9%), 0.0062 (11.7%), 0.0098 (20.1%) and 0.0056 (25.5%) ml/min/ml, respectively, and the biases were -0.0081 (-23.8%), -0.0075 (-23.7%), -0.0107 (-29.5%) and -0.0015 (0.8%) ml/min/ml, respectively.

Conclusion All five methods of quantification (Ki-3k, Ki-Pat, Ki-Spec, Ki-Decon and SUV) strongly correlated with Ki-4k. Although systematic differences of up to 29% were found between Ki-4k and the other methods (Ki-3k, Ki-Pat, Ki-Spec and Ki-Decon), these should not affect the conclusions of clinical studies, provided the methods are applied consistently. However, care should be taken when comparing reports that use different methods of quantification. 

Original languageEnglish
Article numberN/A
Pages (from-to)597-606
Number of pages10
JournalNuclear Medicine Communications
Issue number6
Publication statusPublished - Jun 2012


  • Hip Joint
  • Bone Remodeling
  • Reproducibility of Results
  • Radiopharmaceuticals
  • Humans
  • Fluorodeoxyglucose F18
  • Algorithms
  • Aged
  • Middle Aged
  • Female
  • Positron-Emission Tomography and Computed Tomography
  • Lumbar Vertebrae


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