ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 243

Tracer Uptake from High Resolution Bone SPECT/CT Is Linked to Response in Rheumatoid Arthritis Patients

Yasser Abdelhafez1,2, Felipe Godinez3, Kanika Sood4, Rosalie Hagge2, Ramsey D Badawi2, Robert D Boutin2, Siba P. Raychaudhuri5 and Abhijit Chaudhari6, 1Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt, 2Radiology, Faculty of Medicine, University of California Davis, Sacramento, CA, 3Biomedical Engineering Department, King’s College London, London, United Kingdom, 4Rheumatology Section, Sacramento Veterans Affairs Medical Center, Sacramento, CA, 5Rheumatology, VA Sacramento Medical CenterUC Davis School of Medicine, Mather, CA, 6Radiology, UC Davis School of Medicine, Sacramento, CA

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Sunday, November 5, 2017

Session Title: Imaging of Rheumatic Diseases Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Tracer Uptake from High Resolution Bone SPECT/CT is Linked to Response in Rheumatoid Arthritis Patients.

Background/Purpose:

To evaluate the association between response to TNF-_ blockers and tracer uptake from dual-phase technetium-99m methylene diphosphonate (99mTc-MDP) bone scanning of the hands via a SPECT/CT system in patients with rheumatoid arthritis.

Methods:

Four patients with established rheumatoid arthritis (RA) were enrolled in this IRB-approved prospective pilot study. They were referred for performing bone scan prior to receiving TNF-_ blockers. Early blood pool (15 minutes after tracer injection, marker of hypervascularity) and delayed osseous phase (3 hours after the same injection, marker of osteoblastic activity) scans of the hands using 99mTc-MDP were performed using high-resolution SPECT/CT scanner. A special hand positioning device was designed and used during the scans. Second- to 5th metacarpo-phalangeal joints (MCP) were assessed qualitatively (normal vs. abnormal uptake) and quantitatively (by measuring the maximum counts). All counts were corrected to the background (defined as the median count from all normal joints). Qualitative and quantitative data were assessed against response.

Results:

After a median follow-up of 7.8 months (range: 6.9 Ð 21.7), two patients were considered responders and two were non-responders. A total of 32 joints were assessed. Early and delayed uptake in the 2nd to 5th MCP joints were abnormal in 7 joints, all belong to non-responders; while it was normal in 25 joints, 16 of them were in responders & 9 in non-responders; P = 0.007.

The median corrected counts from delayed scans were 0.92 (range: 0.49-1.49) in responders vs. 1.14 (range: 0.81-2.93) in non-responders; P = 0.002.

The median corrected counts from blood pool scans were 0.95 (range: 0.6-1.67) in responders vs. 1.1 (range: 0.55-2.29) in non-responders; P = 0.2.

Conclusion:

Delayed osseous uptake in metacarpophalangeal joints of rheumatoid arthritis patients, measured from 99mTc-MDP SPECT/CT, performed prior to treatment with TNF-_ blockers, was significantly higher in non-responders compared to responders, which might reflect higher baseline osteoblastic activity in non-responders.

Table 1: Ratio of the counts measured on 2nd to 4th metacarpophalangeal joints in responders and non-responders

Baseline SPECT/CT

Responders

Non-Responders

P

Blood Pool

Median (Range)

0.95 (0.6-1.67)

1.1 (0.55-2.29)

0.184

Mean±SD

0.98±0.32

1.29±0.57

Delayed Phase

Median (Range)

0.92 (0.49-1.49)

1.38±0.61

0.002

Mean±SD

0.88±0.25

1.14 (0.81-2.93)

Figure 1:

Disclosure: Y. Abdelhafez, Philips Healthcare, 2; F. Godinez, Philips Healthcare, 2; K. Sood, Philips Healthcare, 2; R. Hagge, Philips Healthcare, 2; R. D. Badawi, Philips Healthcare, 2; R. D. Boutin, Philips Healthcare, 2; S. P. Raychaudhuri, Philips Healthcare, 2; A. Chaudhari, Philips Healthcare, 2.

To cite this abstract in AMA style:

Abdelhafez Y, Godinez F, Sood K, Hagge R, Badawi RD, Boutin RD, Raychaudhuri SP, Chaudhari A. Tracer Uptake from High Resolution Bone SPECT/CT Is Linked to Response in Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/tracer-uptake-from-high-resolution-bone-spectct-is-linked-to-response-in-rheumatoid-arthritis-patients/. Accessed May 26, 2022.

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