F-18 FDG PET/CT in 26 patients with SAPHO syndrome: a new vision of clinical and bone scintigraphy correlation

Abstract

Backgrounds

Whole-body bone scintigraphy (WBBS) and MRI are widely used in assessment of patients with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. However, the value of F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in SAPHO syndrome was unclear. The aim of this study was to characterize the manifestation of SAPHO syndrome on ¹⁸F-FDG PET/CT and explore its relationship with clinical symptoms and WBBS.

Methods

Twenty-six patients who suffered from SAPHO syndrome and had undergone whole-body ¹⁸F-FDG PET/CT were recruited in Peking Union Medical College Hospital from 2004 to 2016. Clinical manifestations and laboratory findings were recorded for all patients. Imaging data on 18F-FDG PET/CT and WBBS were collected and analyzed retrospectively.

Results

All the 26 patients (20 females and 6 males) exhibited skeletal abnormalities on ¹⁸F-FDG PET/CT. Multiple skeletal lesions affecting the anterior chest wall or spine with low to moderate ¹⁸F-FDG uptake and coexistence of osteolysis and osteosclerosis presented as the typical features of SAPHO syndrome. Sixteen (61.5%) patients had abnormal ¹⁸F-FDG uptake outside the osteoarticular system. PET scan had moderate to substantial agreement with CT and WBBS in revealing lesions in the anterior chest wall and axial skeleton. Nonetheless, the correlation between increased ¹⁸F-FDG uptake and clinical symptoms was weak.

Conclusions

SAPHO syndrome exhibits characteristic features on ¹⁸F-FDG PET/CT. It showed comparable capacity in revealing skeletal lesions with bone scintigraphy.