Nuklearmedizin 2020; 59(02): 152
DOI: 10.1055/s-0040-1708315
Wissenschaftliche Poster
PET, SPECT & Co. II
© Georg Thieme Verlag KG Stuttgart · New York

Increased metabolic activity of appendicular bone marrow in patients with disseminated axial metastases: an FDG-PET/CT study in prostate cancer patients

F Fiz
1   Uni-Klinikum Tübingen, Nuklearmedizin, Tübingen
,
M Bauckneht
2   University of Genoa, Department of Health Sciences, Genoa
,
A Miceli
2   University of Genoa, Department of Health Sciences, Genoa
,
I Donegani
2   University of Genoa, Department of Health Sciences, Genoa
,
M Piana
3   University of Genoa, Department of Mathematics, Genoa
,
G Sambuceti
2   University of Genoa, Department of Health Sciences, Genoa
› Author Affiliations
Further Information

Publication History

Publication Date:
08 April 2020 (online)

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Ziel/Aim Bone metastases from castration-resistant prostate cancer (mCRPC) are a major cause of morbidity of mortality, since they reduce the space available for normal hematopoiesis. In mCRPC, metastastization usually starts in the axial skeleton; the reduction of space in this area might prompt a relocation of active bone marrow to the long bones. In this study, we tested whether presence of bone metastases causes an increase of glucose metabolism in the peripheral bone marrow.

Methodik/Methods Thirty-seven mCRPC patients (mean age 74,8±8,5 years), with bone metastases in the axial skeleton only, underwent a whole-body (vertex to distal tibiae) FDG-PET/CT as a part of staging before a 223RaCl2 therapy. The PET/CT was analyzed with a dedicate program, which automatically segmented the trabecular bone, where the bone marrow (BM) is located. Within BM, a sub-volume comprising voxels with SUV 31,1 was defined according to a published criterion as red bone marrow (RBM). BM and RBM SUVmean, as well as BM SUVmax, were computed and compared with age- and sex-matched controls, randomly chosen from a published normalcy database. Metabolic indices were also compared with the hemoglobin level.

Ergebnisse/Results mCRPC subjects had a higher RBM SUVmean when compared to controls (1,5 ± 0,35 Vs. 1,18 ± 0,12, p < 0.001). There was a direct correlation between RBM SUVmean and Hb level at the time of PET/CT (R = 0,61, p < 0.01). Also, BM SUVmean and SUVmax were significantly higher in mCRPC patients than in controls (0,86 ± 0,11 Vs 0,56 ± 0,13 and 5,86 ± 4,32 Vs. 1,48 ± 0,35, respectively, p < 0.001).

Schlussfolgerungen/Conclusions These data demonstrate the presence of compensatory BM hypermetabolism in the long bones in patients with axial metastases and confirm that this metabolic increase is key in preserving an adequate overall BM function.

 

  • Literatur/References

  • 1 Sambuceti G. et al. Estimating the whole bone-marrow asset in humans by a computational approach to integrated PET/CT imaging. Eur J Nucl Med Mol Imaging . 2012; Aug; 39 ( (08) ): 1326-1338 .
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