18F-sodium fluoride positron emission tomography of the racing Thoroughbred fetlock: Validation and comparison with other imaging modalities in nine horses

Mathieu Spriet, P. Espinosa-Mur, Derek Cissell, Kathryn L Phillips, G. Arino-Estrada, D. Beylin, P. Stepanov, Scott A Katzman, Larry D Galuppo, T. Garcia-Nolen, Brian G Murphy, Susan M Stover

Research output: Contribution to journalArticle

Abstract

Background: Early and accurate detection of stress remodelling in racehorses is of utmost importance to prevent catastrophic injuries. Current imaging techniques have limitations in assessing early changes predisposing to catastrophic breakdowns. Positron emission tomography (PET) using 18F-sodium fluoride (18F-NaF) is a sensitive method for the detection of early bone turnover and may improve early recognition of subtle injuries. Objectives: To validate the clinical use of 18F-NaF PET in Thoroughbred racehorses, to assess the value of PET in the detection of bone lesions and to compare PET results with findings of other advanced imaging modalities, clinical examination and pathology. Study design: Experimental exploratory study. Methods: Twenty fetlocks from nine Thoroughbred racehorses were imaged using 18F-NaF PET, computed tomography (CT) and scintigraphy. Five fetlocks were also imaged with magnetic resonance imaging and four fetlocks were also examined histologically. Imaging findings were independently reviewed by three board certified radiologists. Imaging, clinical and histopathological findings were correlated. Results: PET imaging was well-tolerated by all horses. PET detected focal areas of 18F-NaF uptake in instances where other imaging modalities did not identify abnormalities, in particular in the proximal sesamoid bones. Maximal standardised uptake values could be measured to quantify the activity of lesions. Areas of 18F-NaF uptake corresponded to regions of increased vascularity and increased osteoblastic activity. Main limitations: Limited number of cases. Conclusions: 18F-NaF PET imaging of the Thoroughbred fetlock is feasible and compares favourably with other imaging modalities in detecting stress remodelling in Thoroughbred racehorses. PET appears to be a beneficial imaging modality when used for early detection of stress remodelling in an effort to prevent catastrophic musculoskeletal injuries in this population of horses.

LanguageEnglish (US)
JournalEquine veterinary journal
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

sodium fluoride
positron-emission tomography
Sodium Fluoride
Positron-Emission Tomography
Horses
image analysis
horses
racehorses
lesions (animal)
Wounds and Injuries
Sesamoid Bones
bones
sesamoid bones
Clinical Pathology
Bone Remodeling
scintigraphy
Radionuclide Imaging
computed tomography
magnetic resonance imaging
clinical examination

Keywords

  • bone
  • computed tomography
  • horse
  • magnetic resonance imaging
  • metacarpophalangeal
  • scintigraphy
  • stress

ASJC Scopus subject areas

  • Equine

Cite this

@article{455938d77f1043c9a2e41dc32b911d0b,
title = "18F-sodium fluoride positron emission tomography of the racing Thoroughbred fetlock: Validation and comparison with other imaging modalities in nine horses",
abstract = "Background: Early and accurate detection of stress remodelling in racehorses is of utmost importance to prevent catastrophic injuries. Current imaging techniques have limitations in assessing early changes predisposing to catastrophic breakdowns. Positron emission tomography (PET) using 18F-sodium fluoride (18F-NaF) is a sensitive method for the detection of early bone turnover and may improve early recognition of subtle injuries. Objectives: To validate the clinical use of 18F-NaF PET in Thoroughbred racehorses, to assess the value of PET in the detection of bone lesions and to compare PET results with findings of other advanced imaging modalities, clinical examination and pathology. Study design: Experimental exploratory study. Methods: Twenty fetlocks from nine Thoroughbred racehorses were imaged using 18F-NaF PET, computed tomography (CT) and scintigraphy. Five fetlocks were also imaged with magnetic resonance imaging and four fetlocks were also examined histologically. Imaging findings were independently reviewed by three board certified radiologists. Imaging, clinical and histopathological findings were correlated. Results: PET imaging was well-tolerated by all horses. PET detected focal areas of 18F-NaF uptake in instances where other imaging modalities did not identify abnormalities, in particular in the proximal sesamoid bones. Maximal standardised uptake values could be measured to quantify the activity of lesions. Areas of 18F-NaF uptake corresponded to regions of increased vascularity and increased osteoblastic activity. Main limitations: Limited number of cases. Conclusions: 18F-NaF PET imaging of the Thoroughbred fetlock is feasible and compares favourably with other imaging modalities in detecting stress remodelling in Thoroughbred racehorses. PET appears to be a beneficial imaging modality when used for early detection of stress remodelling in an effort to prevent catastrophic musculoskeletal injuries in this population of horses.",
keywords = "bone, computed tomography, horse, magnetic resonance imaging, metacarpophalangeal, scintigraphy, stress",
author = "Mathieu Spriet and P. Espinosa-Mur and Derek Cissell and Phillips, {Kathryn L} and G. Arino-Estrada and D. Beylin and P. Stepanov and Katzman, {Scott A} and Galuppo, {Larry D} and T. Garcia-Nolen and Murphy, {Brian G} and Stover, {Susan M}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/evj.13019",
language = "English (US)",
journal = "Equine veterinary journal. Supplement",
issn = "2042-3306",
publisher = "British Equine Veterinary Association",

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TY - JOUR

T1 - 18F-sodium fluoride positron emission tomography of the racing Thoroughbred fetlock

T2 - Equine veterinary journal. Supplement

AU - Spriet, Mathieu

AU - Espinosa-Mur, P.

AU - Cissell, Derek

AU - Phillips, Kathryn L

AU - Arino-Estrada, G.

AU - Beylin, D.

AU - Stepanov, P.

AU - Katzman, Scott A

AU - Galuppo, Larry D

AU - Garcia-Nolen, T.

AU - Murphy, Brian G

AU - Stover, Susan M

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Early and accurate detection of stress remodelling in racehorses is of utmost importance to prevent catastrophic injuries. Current imaging techniques have limitations in assessing early changes predisposing to catastrophic breakdowns. Positron emission tomography (PET) using 18F-sodium fluoride (18F-NaF) is a sensitive method for the detection of early bone turnover and may improve early recognition of subtle injuries. Objectives: To validate the clinical use of 18F-NaF PET in Thoroughbred racehorses, to assess the value of PET in the detection of bone lesions and to compare PET results with findings of other advanced imaging modalities, clinical examination and pathology. Study design: Experimental exploratory study. Methods: Twenty fetlocks from nine Thoroughbred racehorses were imaged using 18F-NaF PET, computed tomography (CT) and scintigraphy. Five fetlocks were also imaged with magnetic resonance imaging and four fetlocks were also examined histologically. Imaging findings were independently reviewed by three board certified radiologists. Imaging, clinical and histopathological findings were correlated. Results: PET imaging was well-tolerated by all horses. PET detected focal areas of 18F-NaF uptake in instances where other imaging modalities did not identify abnormalities, in particular in the proximal sesamoid bones. Maximal standardised uptake values could be measured to quantify the activity of lesions. Areas of 18F-NaF uptake corresponded to regions of increased vascularity and increased osteoblastic activity. Main limitations: Limited number of cases. Conclusions: 18F-NaF PET imaging of the Thoroughbred fetlock is feasible and compares favourably with other imaging modalities in detecting stress remodelling in Thoroughbred racehorses. PET appears to be a beneficial imaging modality when used for early detection of stress remodelling in an effort to prevent catastrophic musculoskeletal injuries in this population of horses.

AB - Background: Early and accurate detection of stress remodelling in racehorses is of utmost importance to prevent catastrophic injuries. Current imaging techniques have limitations in assessing early changes predisposing to catastrophic breakdowns. Positron emission tomography (PET) using 18F-sodium fluoride (18F-NaF) is a sensitive method for the detection of early bone turnover and may improve early recognition of subtle injuries. Objectives: To validate the clinical use of 18F-NaF PET in Thoroughbred racehorses, to assess the value of PET in the detection of bone lesions and to compare PET results with findings of other advanced imaging modalities, clinical examination and pathology. Study design: Experimental exploratory study. Methods: Twenty fetlocks from nine Thoroughbred racehorses were imaged using 18F-NaF PET, computed tomography (CT) and scintigraphy. Five fetlocks were also imaged with magnetic resonance imaging and four fetlocks were also examined histologically. Imaging findings were independently reviewed by three board certified radiologists. Imaging, clinical and histopathological findings were correlated. Results: PET imaging was well-tolerated by all horses. PET detected focal areas of 18F-NaF uptake in instances where other imaging modalities did not identify abnormalities, in particular in the proximal sesamoid bones. Maximal standardised uptake values could be measured to quantify the activity of lesions. Areas of 18F-NaF uptake corresponded to regions of increased vascularity and increased osteoblastic activity. Main limitations: Limited number of cases. Conclusions: 18F-NaF PET imaging of the Thoroughbred fetlock is feasible and compares favourably with other imaging modalities in detecting stress remodelling in Thoroughbred racehorses. PET appears to be a beneficial imaging modality when used for early detection of stress remodelling in an effort to prevent catastrophic musculoskeletal injuries in this population of horses.

KW - bone

KW - computed tomography

KW - horse

KW - magnetic resonance imaging

KW - metacarpophalangeal

KW - scintigraphy

KW - stress

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U2 - 10.1111/evj.13019

DO - 10.1111/evj.13019

M3 - Article

JO - Equine veterinary journal. Supplement

JF - Equine veterinary journal. Supplement

SN - 2042-3306

ER -