Bone metabolic activity measured with positron emission tomography and [18F]fluoride ion in renal osteodystrophy: correlation with bone histomorphometry

J Clin Endocrinol Metab. 1993 Oct;77(4):949-55. doi: 10.1210/jcem.77.4.8408470.


We evaluated the bone metabolic activity in patients with renal osteodystrophy using positron emission tomography and [18F]fluoride ion. Eight patients had secondary hyperparathyroidism (HPT), and three had low-turnover bone disease. Eleven normal subjects were also studied, and three of the eight HPT patients were reevaluated after therapy. A rate constant (K) describing the net transport of [18F] fluoride ion into a bound compartment in bone was calculated using both a three-compartment model and Patlak graphical analysis. Values of K were compared with biochemical data and with histomorphometric indices. The results indicate that K is significantly higher (P < 0.01) in HPT patients than in normal subjects and patients with low-turnover bone disease. Values of K correlated with serum alkaline phosphatase (r = 0.81) and PTH (r = 0.93) levels and with histomorphometric indices of bone formation rate (r = 0.84, P < 0.01) and eroded perimeter (r = 0.77, P < 0.05). Values of K decreased by 40 and 30%, respectively, in two patients who underwent parathyroidectomy and medical therapy. Positron emission tomography studies of bone using [18F]fluoride ion can differentiate low turnover from high turnover lesions of renal osteodystrophy and provide quantitative estimates of bone cell activity that correlate with histomorphometric data.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Alkaline Phosphatase / blood
  • Alkaline Phosphatase / metabolism
  • Bone Resorption
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / metabolism*
  • Bone and Bones / pathology
  • Calcitriol / therapeutic use
  • Calcium / blood
  • Calcium / metabolism
  • Chronic Kidney Disease-Mineral and Bone Disorder / complications
  • Chronic Kidney Disease-Mineral and Bone Disorder / drug therapy
  • Chronic Kidney Disease-Mineral and Bone Disorder / metabolism*
  • Female
  • Fluorine Radioisotopes
  • Humans
  • Hyperparathyroidism, Secondary / etiology*
  • Hyperparathyroidism, Secondary / therapy
  • Male
  • Middle Aged
  • Models, Theoretical
  • Parathyroid Glands / pathology
  • Parathyroid Glands / surgery
  • Parathyroid Hormone / blood
  • Parathyroid Hormone / metabolism
  • Phosphorus / blood
  • Phosphorus / metabolism
  • Regression Analysis
  • Tomography, Emission-Computed


  • Fluorine Radioisotopes
  • Parathyroid Hormone
  • Phosphorus
  • Alkaline Phosphatase
  • Calcitriol
  • Calcium