Differential effects of teriparatide on regional bone formation using (18)F-fluoride positron emission tomography

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Abstract

Teriparatide increases skeletal mass, bone turnover markers, and bone strength, but local effects on bone tissue may vary between skeletal sites. We used positron emission tomography (PET) to study (18)F-fluoride plasma clearance (K(i)) at the spine and standardized uptake values (SUVs) at the spine, pelvis, total hip, and femoral shaft in 18 postmenopausal women with osteoporosis. Subjects underwent a 1-hour dynamic scan of the lumbar spine and a 10-minute static scan of the pelvis and femurs at baseline and after 6 months of treatment with 20 µg/day teriparatide. Blood samples were taken to derive the arterial input function and lumbar spine K(i) values evaluated using a three-compartment model. SUVs were calculated for the spine, pelvis, total hip, and femoral shaft. After 6 months treatment with teriparatide, spine K(i) values increased by 24% (p = .0003), while other model parameters were unchanged except for the fraction of tracer going to bone mineral (k(3)/[k(2) + k(3)]), which increased by 23% (p = .0006). In contrast to K(i) , spine SUVs increased by only 3% (p = .84). The discrepancy between changes in K(i) and SUVs was explained by a 20% decrease in (18)F(-) plasma concentration. SUVs increased by 37% at the femoral shaft (p = .0019), 20% at the total hip (p = .032), and 11% at the pelvis (p = .070). Changes in bone turnover markers and BMD were consistent with previous trials. We conclude that the changes in bone formation rate during teriparatide treatment as measured by (18)F(-) PET differ at different skeletal sites, with larger increases in cortical bone than at trabecular sites.
Original languageEnglish
Pages (from-to)1002 - 1011
Number of pages10
JournalJournal of Bone and Mineral Research
Volume26
Issue number5
DOIs
Publication statusPublished - May 2011

Keywords

  • Bone Remodeling
  • Bone and Bones
  • Positron-Emission Tomography
  • Teriparatide
  • Humans
  • Aged
  • Demography
  • Fluorine Radioisotopes
  • Bone Density
  • Middle Aged
  • Fluorides
  • Statistics, Nonparametric
  • Biological Markers
  • Female
  • Osteogenesis

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