¹⁸F-FPRGD₂ PET/CT imaging of musculoskeletal disorders

Ann Nucl Med. 2015 Dec;29(10):839-47. doi: 10.1007/s12149-015-1011-5. Epub 2015 Aug 8.


Objective: This work reports on musculoskeletal uptake of ¹⁸F-FPRGD₂, targeting the integrin αvβ3, in patients who had undergone ¹⁸F-FPRGD₂ positron emission tomography combined with computed tomography (PET/CT) for oncologic purposes.

Methods: Whole-body ¹⁸F-FPRGD₂ PET/CT images of 62 cancer patients were retrospectively reviewed to detect foci of musculoskeletal ¹⁸F-FPRGD₂ uptake. For 37 patients, a FDG PET/CT performed in clinical settings was available. In each joint with an abnormal uptake, the maximum standardized uptake value (SUVmax) was estimated.

Results: A total of 260 musculoskeletal foci of ¹⁸F-FPRGD₂ uptake were detected. Most common sites of uptake were joints and discs (n = 160; 61.5%), entheses (osteotendinous and osteoligamentous junctions; n = 55; 21.2%) and recent fractures (n = 18; 6.9%). In addition, 27 (10.4%) miscellaneous foci were detected. Out of the 146 lesions for which a FDG PET was available, 63% showed both ¹⁸F-FPRGD₂ and FDG uptake, 33.6% did not show FDG avidity and 3.4% showed only FDG uptake. The uptake intensity of the 92 lesions positive with ¹⁸F-FPRGD₂ and FDG was similar with both radiopharmaceuticals, but the target-to-background (blood pool or muscle) ratios were significantly higher with ¹⁸F-FPRGD₂ than with FDG (p < 0.0001).

Conclusion: The ¹⁸F-FPRGD₂ uptake in joints, spine degenerative diseases and tendons was highly prevalent in our population. Up to one-third of ¹⁸F-FPRGD₂ foci showed no FDG uptake suggesting that ¹⁸F-FPRGD₂ signal may not be related to inflammatory angiogenesis only.

Keywords: Discopathy; Integrin; Joint; Osteoarthritis; PET; RGD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / complications
  • Adult
  • Aged
  • Aged, 80 and over
  • Biological Transport
  • Cartilage / metabolism
  • Cell Dedifferentiation
  • Chondrocytes / metabolism
  • Cohort Studies
  • Female
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging*
  • Musculoskeletal Diseases / complications
  • Musculoskeletal Diseases / diagnostic imaging*
  • Musculoskeletal Diseases / metabolism
  • Oligopeptides*
  • Osteoarthritis / pathology
  • Peptides, Cyclic*
  • Positron-Emission Tomography*
  • Radiation Dosage
  • Rectal Neoplasms / complications
  • Retrospective Studies
  • Tomography, X-Ray Computed*


  • FB-mini-PEG-E(c(RGDyK))2
  • Oligopeptides
  • Peptides, Cyclic
  • arginyl-glycyl-aspartic acid