BoneKEy Reports | BoneKEy Watch
18F-PET scans measure response to teriparatide non invasively
DOI:10.1038/bonekey.2013.74
Frost et al. sought to determine whether functional imaging with 18F-fluoride positron emission tomography (18F-PET) could be used to monitor early response to teriparatide (TPT) treatment. In this small study, 13 post-menopausal women diagnosed with osteopenia were treated with TPT 20 μg daily for 12 weeks, while a further 14 women acted as a control group. All women received daily calcium and vitamin D.
Comparisons were made between 18F-PET analyses performed at baseline at the lumbar spine, pelvis, proximal femur and hip and those performed at 12 weeks. The rate at which 18F-fluoride is cleared from the plasma to bone is a validated indicator of bone formation, and a significant increase in this value was apparent at all sites in the TPT group. Increases of 27% (total hip), 21% (trabecular hip), 25% (femoral neck), 18% (lumbar spine), 42% (pelvis) and 51% (cortical hip) were observed, and all reached significance.
Editor’s comment: A transient decrease of hip bone mineral density has been observed in patients who switched to TPT and we still lack direct evidence that TPT treatment decreases the incidence of hip fractures. Non-invasive evaluations of changes in hip bone structure and density distribution have consequently emerged as important indirect methods of assessing the effect of TPT on hip strength. The new technology applied here to evaluate regional bone formation shows a dramatic positive therapeutic effect at the trabecular and cortical hip, as well as the spine and pelvis.
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