Quantification of osteoblastic activity in epiphyseal growth plates by quantitative bone SPECT/CT
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Quantifying the function of the epiphyseal plate is worthwhile for the management of children with growth disorders. The aim of this retrospective study was to quantify the osteoblastic activity at the epiphyseal plate using the quantitative bone SPECT/CT.
Materials and methods
We enrolled patients under the age of 20 years who received Tc-99m hydroxymethylene diphosphonate bone scintigraphy acquired by a quantitative SPECT/CT scanner. The images were reconstructed by ordered subset conjugate-gradient minimizer, and the uptake on the distal margin of the femur was quantified by peak standardized uptake value (SUVpeak). A public database of standard body height was used to calculate growth velocities (cm/year).
Fifteen patients (6.9–19.7 years, 9 female, 6 male) were enrolled and a total of 25 legs were analyzed. SUVpeak in the epiphyseal plate was 18.9 ± 2.4 (average ± standard deviation) in the subjects under 15 years and decreased gradually by aging. The SUVpeak correlated significantly with the age- and sex-matched growth velocity obtained from the database (R2 = 0.83, p < 0.0001).
The SUV measured by quantitative bone SPECT/CT was increased at the epiphyseal plates of children under the age of 15 years in comparison with the older group, corresponding to higher osteoblastic activity. Moreover, this study suggested a correlation between growth velocity and the SUV. Although this is a small retrospective pilot study, the objective and quantitative values measured by the quantitative bone SPECT/CT has the potential to improve the management of children with growth disorder.
KeywordsEpiphyseal plate Tc-99m Hydroxymethylene diphosphonate xSPECT bone Ordered subset conjugate gradient minimizer Standardized uptake value
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflicts of interest.
- 3.Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. Stanford: Stanford University Press; 1959.Google Scholar
- 4.Tanner JM. Assessment of skeletal maturity and prediction of adult height (TW3 method). Philadelphia: Saunders; 2001.Google Scholar
- 9.Kelly HW, Van Natta ML, Covar RA, Tonascia J, Green RP, Strunk RC. Effect of long-term corticosteroid use on bone mineral density in children: a prospective longitudinal assessment in the childhood asthma management program (CAMP) study. Pediatrics. 2008;122(1):e53–61.CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Koizumi K, Masaki H, Matsuda H, Uchiyama M, Okuno M, Oguma E, et al. Japanese consensus guidelines for pediatric nuclear medicine. Part 1: Pediatric radiopharmaceutical administered doses (JSNM pediatric dosage card). Part 2: technical considerations for pediatric nuclear medicine imaging procedures. Ann Nucl Med. 2014;28(5):498–503.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.International Commission on Radiological Protection. Radiation dose to patients from radiopharmaceuticals (Addendum to ICRP Publication 53). ICRP Publication 80. Ann ICRP. 1998; 28(3).Google Scholar
- 20.Ministry of Education, Culture, Sports, Science and Technology. Annual Report of School Health Statistics Research. Tokyo, Japan: Ministry of Education, Culture, Sports, Science and Technology 2015.Google Scholar
- 22.International Commission on Radiological Protection. Basic anatomical and physiological data for use in radiological protection: reference values. A report of age- and gender-related differences in the anatomical and physiological characteristics of reference individuals. ICRP publication 89. Ann ICRP. 2002;32(3-4):5–265.Google Scholar
- 23.Tanaka T. Bone age atlas for Japanese children. Tokyo: Medical View; 2011.Google Scholar