Novel technique of detecting inflammatory and osseous changes in the glenohumeral joint associated with patient age and weight using FDG- and NaF-PET imaging

Peter Sang Uk Park; Lori Jia; William Y Raynor; Om H Gandhi; Mia Mijung Park; Thomas J Werner; Poul Flemming Høilund-Carlsen; Abass Alavi

Novel technique of detecting inflammatory and osseous changes in the glenohumeral joint associated with patient age and weight using FDG- and NaF-PET imaging

Am J Nucl Med Mol Imaging. 2023 Aug 15;13(4):136-146. eCollection 2023.

Authors

Peter Sang Uk Park¹, Lori Jia¹, William Y Raynor¹, Om H Gandhi¹, Mia Mijung Park¹, Thomas J Werner¹, Poul Flemming Høilund-Carlsen^{2

3}, Abass Alavi¹

Affiliations

¹ Department of Radiology, Hospital of The University of Pennsylvania Philadelphia, PA, The United States.
² Department of Nuclear Medicine, Odense University Hospital Odense, Denmark.
³ Department of Clinical Research, University of Southern Denmark Odense, Denmark.

PMID: 37736491
PMCID: PMC10509288

Abstract

Objective: The glenohumeral (GH) joint is a classic ball-and-socket joint of the shoulder subject to various pathologies including osteoarthritis (OA). Degenerative changes of the OA evident on traditional imaging are proceeded by molecular changes, which if detected early could enhance disease prevention and treatment. In this study, we use ¹⁸F-FluoroDeoxyGlucose (FDG) and ¹⁸F-sodium-fluoride (NaF)-PET/CT to investigate the effects limb laterality, age, and BMI on the inflammation and bone turnover of the GH shoulder joint.

Methods: FDG and NaF-PET/CT scans of 41 females (mean age of 43.9 ± 14.2 years) and 45 males (mean age of 44.5 ± 13.8 years) were analyzed with a semi-quantitative technique based on predefined region of interest.

Results: There was greater FDG uptake in the left side of the GH joint compared to the right in both females (left: 0.79 ± 0.17, right: 0.71 ± 0.2; P < 0.0001) and males (left: 0.76 ± 0.19, right: 0.57 ± 0.18; P < 0.0001). We also observed a strong positive association between BMI and FDG uptakes in females (left: P < 0.0001, r = 0.71, right: P < 0.0001, r = 0.58) and males (left: P < 0.0001, r = 0.56, right: P < 0.0001, r = 0.64). Association between BMI and NaF uptake were found in males as well (left: P = 0.004, r = 0.42, right: P = 0.02, r = 0.35).

Conclusion: Our study demonstrates the varying effect of limb laterality and BMI on FDG and NaF uptake at the GH joint. Adoption of molecular imaging will require future studies that correlate tracer uptake with relevant medical and illness history as well as degenerative change evident on traditional imaging.

Keywords: BMI; FDG; Glenohumeral joint; NaF; PET; aging; arthritis; limb laterality.