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. 2019 Oct 31;3(1):18.
doi: 10.1186/s41824-019-0065-3.

18F-NaF PET/CT imaging of bone formation induced by bioactive glass S53P4 after mastoid obliteration

Adriana J Timmermans  1 , Jasper J Quak  1 , Petronella J Hagen  2 , David R Colnot  3
Affiliations

18F-NaF PET/CT imaging of bone formation induced by bioactive glass S53P4 after mastoid obliteration

Adriana J Timmermans et al. Eur J Hybrid Imaging. .

Abstract

Purpose: Bioactive glass has been successfully used for surgical treatment of chronic infections in bone and bone cavities. Besides infection control, new bone formation is induced by the bioactive glass which is considered to have osteoconductive properties. Evaluation of postsurgical changes after bone graft surgery is generally performed with conventional radiographs or CT/MR imaging, but 18F-NaF PET/CT might be more suitable since it has a high and rapid bone uptake, accompanied by a fast blood clearance leading to a high bone to background ratio.

Case: Obliteration with S53P4 bioactive glass of the mastoid and middle ear was performed in a patient suffering from chronic otitis media. Control of the chronic otitis media was achieved, and follow-up imaging after 3 years with 18F-NaF PET/CT showed increased uptake in the obliterated cavity indicating new bone formation.

Conclusion: 18F-NaF PET/CT is able to detect new bone formation after obliteration of the mastoid with S53P4 bioactive glass.

Keywords: 18F-NaF PET/CT; Bioactive glass; Chronic otitis media; Obliteration; S53P4.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Axial CT of the right mastoid showing a homogenous distribution of the bioactive glass S53P4 in the cavity of the middle ear and mastoid with a central hypodense area considered to represent seroma or fluid. b T2-weighted axial MRI of the same level
Fig. 2
Fig. 2
Axial 18F-FDG-PET/CT revealing increased uptake of the obliterated area, without uptake in the centrally located fluid area. The FDG uptake was considered too low for infection, but more likely a visualization of metabolic activity in the obliterated mastoid and middle ear cavity
Fig. 3
Fig. 3
18F-NaF PET/CT showing increased uptake of 18F-NaF at the edges of the obliterated cavity. It was considered as osteoblast activity induced by bioactive glass S53P4 indicating formation of new bone
Fig. 4
Fig. 4
Histological specimen taken from an obliterated mastoid in a patient who underwent revision surgery for cholesteatoma showing osteoblast ingrowth between S53P4 glass granules indicating formation of new bone
See this image and copyright information in PMC

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