{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:29:55Z","timestamp":1792477795444,"version":"4.5.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the emerging role of Tc-99m-labeled diphosphonate (Tc-99m-DPD) uptake quantification by SPECT\/CT in fibrous dysplasia (FD) bone lesions and its correlation with biological bone turnover markers (BTMs) of disease activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Seven patients (49 \u00b1 16 years) with a confirmed diagnosis of FD were included in this retrospective study. Bone scans with Tc-99m-DPD and quantitative SPECT\/CT (xSPECT\/CT) were performed. SUV<jats:sub>max<\/jats:sub> (maximum standard unit value) and SUV<jats:sub>mean<\/jats:sub> (mean standard unit value) were measured in all FD bone lesions. The skeletal burden score (SBS) was assessed on planar scintigraphy and multiplied by mean SUV<jats:sub><jats:italic>max<\/jats:italic><\/jats:sub> and SUV<jats:sub>mean<\/jats:sub> to generate two new parameters, SBS_SUV<jats:sub>max<\/jats:sub> and SBS_SUV<jats:sub>mean<\/jats:sub>, respectively. Planar and xSPECT\/CT quantitative measures were correlated with biological BTMs of disease activity, including fibroblast growth factor 23 (FGF-23), alkaline phosphatase (ALP), procollagen 1 intact N-terminal propeptide (P1NP) and C-terminal telopeptide (CTX), as well as scoliosis angle measured on radiographs. Statistical significance was evaluated with Spearman\u2019s correlations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 76 FD bone lesions were analyzed, showing an average SUV<jats:sub>max<\/jats:sub> and SUV<jats:sub>mean<\/jats:sub> (g\/mL) of 13 \u00b1 7.3 and 8 \u00b1 4.5, respectively. SBS, SBS_SUV<jats:sub>max<\/jats:sub> and SBS_SUV<jats:sub>mean<\/jats:sub> values were 30.8 \u00b1 25.6, 358 \u00b1 267 and 220.1 \u00b1 164.5, respectively. Mean measured values of FGF-23 (pg\/mL), ALP (U\/L), P1NP (\u03bcg\/L) and CTX (pg\/mL) were 98.4 (22\u2013175), 283.5 (46\u2013735), 283.1 (31\u20131,161) and 494 (360\u2013609), respectively. Mean scoliosis angle was 15.7 (7\u201322) degrees. We found a very strong positive correlation between planar-derived SBS and CTX (<jats:italic>r<\/jats:italic> = 0.96, <jats:italic>p<\/jats:italic> = 0.010), but no significant correlation between SUV<jats:sub>max<\/jats:sub> or SUV<jats:sub>mean<\/jats:sub> and biological BTMs. SBS_SUV<jats:sub>max<\/jats:sub> showed a strong to very strong positive correlation with CTX (\u03c1 = 0.99, <jats:italic>p<\/jats:italic> = 0.002), FGF-23 (\u03c1 = 0.91, <jats:italic>p<\/jats:italic> = 0.010), ALP (\u03c1 = 0.82, <jats:italic>p<\/jats:italic> = 0.020), and P1NP (\u03c1 = 0.78, <jats:italic>p<\/jats:italic> = 0.039), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study showed that biological BTMs are significantly correlated with diphosphonate uptake on bone scan, quantified by a new parameter combining information from both planar and quantitative SPECT\/CT. Further analysis of bone scan quantitative SPECT\/CT data in a larger patient population might help better characterize the skeletal disease burden in FD, and guide treatment and follow-up.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.1050854","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T04:35:38Z","timestamp":1669350938000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["A novel approach for fibrous dysplasia assessment using combined planar and quantitative SPECT\/CT analysis of Tc-99m-diphosphonate bone scan in correlation with biological bone turnover markers of disease activity"],"prefix":"10.3389","volume":"9","author":[{"given":"Mario","family":"Jreige","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Becce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9reng\u00e8re","family":"Aubry-Rozier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Gonzalez Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklaus","family":"Schaefer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John O.","family":"Prior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Nicod Lalonde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1159\/000058106","article-title":"Fibrous dysplasia.","volume":"57","author":"Schoenau","year":"2002","journal-title":"Horm Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1210\/endrev\/bnz011","article-title":"Fibrous dysplasia\/mccune-albright syndrome: a rare, mosaic disease of g\u03b1s activation.","volume":"41","author":"Boyce","year":"2019","journal-title":"Endocr Rev."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1177\/2047981613492532","article-title":"Mazabraud\u2019s syndrome: case report and literature review.","volume":"2","author":"Munksgaard","year":"2013","journal-title":"Acta Radiol Short Rep."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1848","DOI":"10.2106\/JBJS.D.02942","article-title":"Fibrous dysplasia. 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