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Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association2023; 64(3); 492-500; doi: 10.1111/vru.13225

Establishment of a sequential dual tracer 18 F-NaF/18 F-FDG PET protocol for imaging the equine foot.

Abstract: The combination of F-Sodium Fluoride ( F-NaF) and F-FluoroDeoxyGlucose ( F-FDG) for positron emission tomography (PET) imaging of the equine foot is appealing for detection of both osseous and soft tissue lesions in a single scan. As the combination of tracers could lead to a loss of information, a sequential approach, consisting in imaging with one tracer prior to injecting the second tracer, might be valuable. The goals of this prospective, methods comparison, exploratory study were to establish the order of tracer injection and timing for imaging. Six research horses were imaged under general anesthesia with F-NaF PET, F-FDG PET, dual F-NaF/ F-FDG PET, and CT. Proper uptake could be identified in tendon lesions as early as 10 min after 18F-FDG injection. Bone uptake was limited when 18F-NaF was injected under general anesthesia, even at 1 h after injection, when compared with F-NaF injection prior to anesthesia. The sensitivity and specificity of the dual tracer scans were 0.77 (0.63 to 0.86) and 0.98 (0.96 to 0.99) respectively, to assess F-NaF uptake and 0.5 (0.28 to 0.72) and 0.98 (0.95 to 0.99), respectively, for 18F-FDG uptake. These results suggest that the sequential dual tracer approach is a pertinent technique to optimize the PET data gained from a single anesthetic episode. Based on dynamics of tracer uptake, the optimal protocol consists in injecting 18F-NaF prior to anesthesia, acquire 18F-NaF data then inject 18F-FDG and start acquisition of dual tracer PET data 10 min later. This protocol should be further validated in a larger clinical study.
© 2023 American College of Veterinary Radiology.
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Publication Date: 2023-03-04 PubMed ID: 36870052DOI: 10.1111/vru.13225Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study presents a new approach to imaging the horse’s foot using two tracers in a positron emission tomography (PET) scan. The research aimed to establish the most effective order and timing for these two types of tracer in order to optimize PET data from a single session under anesthetic.

Explanation of the Research

  • An innovative protocol for imaging tendons, soft tissues, and osseous structures (bones) in a horse’s foot is presented using dual tracers – F-Sodium Fluoride (F-NaF) and F-FluoroDeoxyGlucose (F-FDG) – in a positron emission tomography (PET). Applying both tracers in a single scan is proposed to diagnose differing types of lesions without having to run multiple scans. However, this combined use may have the drawback of losing information.
  • To confront these issues and optimise data, a sequential approach is taken. This involves imaging with the first tracer before the next one is initiated. This study is set out to understand the best sequence of tracers and the timing for the images. The research is exploratory – an effort to concretize the methodology.
  • Two categories of tracers, F-NaF and F-FDG, were applied at different stages in six horses. First, a scan was run for each tracer, followed by a dual scan using both. In addition, CT scans were also done.

Findings of the Research

  • The uptake of 18F-FDG occurs quickly; proper identification of lesions in tendons could be found as soon as 10 minutes post-injection.
  • However, 18F-NaF uptake was lower when injected under general anaesthesia. This was confirmed by comparing it with F-NaF injection given prior to the anaesthesia.
  • The sensitivity (precision in correctly identifying the condition) and specificity (accuracy in not falsely identifying healthy individuals as sick) of dual tracer scans were calculated for the two tracers. F-NaF uptake had a sensitivity of 0.77 and a specificity of 0.98. As for 18F-FDG uptake, the sensitivity was 0.50 and the specificity was 0.98.
  • These findings provide reasoning for the adoption of the sequential dual tracer approach in order to get the best possible PET details from one anesthetic procedure.
  • According to the research, the ideal protocol is to inject 18F-NaF prior to anesthesia, collect the 18F-NaF data, then inject 18F-FDG and start the dual tracer PET data collection 10 minutes afterward. This recommended protocol certainly requires further validation on a larger scale in clinical trials.

Cite This Article

APA
Spriet M, Espinosa-Mur P, Zhang X, Berg E, Bec J, Katzman S, Galuppo L. (2023). Establishment of a sequential dual tracer 18 F-NaF/18 F-FDG PET protocol for imaging the equine foot. Vet Radiol Ultrasound, 64(3), 492-500. https://doi.org/10.1111/vru.13225

Publication

Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
ISSN: 1740-8261
NlmUniqueID: 9209635
Country: England
Language: English
Volume: 64
Issue: 3
Pages: 492-500

Researcher Affiliations

Spriet, Mathieu
  • School of Veterinary Medicine, University of California Davis, Davis, California, USA.
Espinosa-Mur, Pablo
  • School of Veterinary Medicine, University of California Davis, Davis, California, USA.
Zhang, Xuezhu
  • College of Biomedical Engineering, University of California Davis, Davis, California, USA.
Berg, Eric
  • College of Biomedical Engineering, University of California Davis, Davis, California, USA.
Bec, Julien
  • College of Biomedical Engineering, University of California Davis, Davis, California, USA.
Katzman, Scott
  • School of Veterinary Medicine, University of California Davis, Davis, California, USA.
Galuppo, Larry
  • School of Veterinary Medicine, University of California Davis, Davis, California, USA.

MeSH Terms

  • Horses
  • Animals
  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals
  • Sodium Fluoride
  • Prospective Studies
  • Positron-Emission Tomography / veterinary
  • Positron-Emission Tomography / methods

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This article includes 20 references
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