Prevalence of low trabecular bone score and its association with disease severity and activity in patients with axial spondyloarthritis.

Axial spondyloarthritis (axSpA) increases the risk of osteoporosis and vertebral fractures. Bone mineral density (BMD) measured by dual X-ray absorptiometry (DXA) has limitations in axSpA patients. Trabecular bone score (TBS) indirectly assesses bone microarchitecture and can be used to predict fracture risk. However, few studies have investigated the role of TBS in axSpA patients. The objective of this study were to compare TBS between axSpA patients and 1:1 sex- and age-matched healthy volunteers and determine factors associated with low TBS in axSpA patients. A cross-sectional study was conducted in two tertiary-care hospitals. A total of 137 axSpA patients and healthy volunteers were enrolled. Demographics, disease characteristics, and risk factors for osteoporosis were recorded. TBS, BMD at the lumbar spine, hip, and vertebral fractures were assessed by DXA. Low TBS was defined as a TBS value < 1.230. Factors associated with low TBS were examined by logistic regression. Most patients were male (75.9%) and tested positive for HLA-B27 (88.3%). The mean (SD) age was 42.8 (12.0) years. The mean (SD) of TBS in the axSpA patients was lower than those in the healthy volunteers [1.402 (0.107) vs 1.440 (0.086), respectively; p = 0.002]. The mean (SD) of lumbar BMD in the axSpA patients was higher than in healthy volunteers [1.186 (0.212) vs 1.087 (0.124), p < 0.001], whereas the mean (SD) of femoral neck BMD in the axSpA group was lower than that in the healthy volunteers [0.867 (0.136) vs 0.904 (0.155), p = 0.038]. Disease severity as indicated by sacroiliac joint fusion and a high ASDAS score were associated with low TBS with the odds ratios (95% confidence interval) of 11.8 (1.2-115.4) and 5.2 (1.6-16.9), respectively. In conclusion, axSpA patients had a higher prevalence of low TBS than healthy volunteers. Sacroiliac joint fusion and a high ASDAS score were associated with low TBS.

18F-FDG PET/CT findings in endometrial cancer patients: the correlation between SUVmax and clinicopathologic features.

OBJECTIVE: To study 18F-FDG PET/CT findings in endometrial cancer patients, to analyze the correlation between the maximum standardized uptake value (SUVmax) and clinicopathologic tumor characteristics. MATERIAL AND METHOD: Retrospective study included 33 endometrial cancer patients who underwent pre-operative 18F-FDG PET/CT and abdominal CT or MRI from June 2005 to October 2009. Pattern of FDG uptake was classified as focal and diffuse uptake. SUVmax was measured at primary tumor in endometrial cavity and correlated with maximum tumor size, menopausal state, histological grade, depth of myometrial invasion and nodal metastasis. The diagnostic performance of 18F-FDG PET/CT was assessed for primary tumor and lymph node metastasis and correlated with those of CT/MRI. RESULTS: Sensitivity of 18F-FDG PET/CT in primary tumor detection was slightly higher, without significant difference, than that of either CT or MRI (93.9% vs. 87.9%, p = 0.625). The overall SUVmax mean ofthe primary tumor was 8.24 +/- 5.38. The focal FDG uptake pattern was more common than the diffuse uptake pattern (71.0% and 29.0%, respectively), but the SUVmax was higher in the diffuse uptake pattern (diffuse pattern 12.10 +/- 7.47 vs. focal pattern 6.66 +/- 3.33, p = 0.008). There was significant association between the SUVmax of the primary tumor and maximum tumor size (p = 0.001), but not between the SUVmax of the primary tumor and menopause state, histological grade, depth of myometrial invasion and nodal metastasis (p = 0.522, 0.622, 0.694 and 0.601, respectively). For lymph node detection, the sensitivity of 18F-FDG PET/CT were also higher without statistically significant difference, than those of CT/MRI (on patient basis; 80.0% vs. 40.0%, p = 0.500; on nodal basis 64.7% vs. 47.1%, p = 0.453, respectively). CONCLUSION: 18F-FDG PET/CThad slightly higher diagnostic sensitivity than CT/MRIin both primary tumor and lymph node detection. The finding focal uptake pattern is more common, but the diffuse uptake pattern shows higher FDG uptake. The SUVmax of primary tumors was associated with the maximum tumor size, but not associated with menopause state, histologic grade, depth of myometrial invasion and nodal metastasis.

A comparative study of bone mineral density between premenopausal women with hyperthyroidism and healthy premenopausal women.

OBJECTIVE: To compare bone mineral density (BMD) of the lumbar spine (L1-L4), total hip (TH), and femoral neck (FN) analyzed by Dual Energy X-ray Absorptiometry (DXA) in premenopausal women with hyperthyroidism and in healthy premenopausal women. MATERIAL AND METHOD: Cross-sectional study included 49 premenopausal women with hyperthyroidism and 49 healthy premenopausal women. Age, weight and body mass index (BMI) were comparable in both groups. All subjects had a BMD measurement by DXA in the region of L1-L4, TH and FN and the unpaired t-test was used to analyze. RESULTS: The mean BMD of premenopausal women with hyperthyroidism at L1-L4, TH and FN was 0.928, 0.838 and 0.774 g/cm2, which were lower than those of healthy premenopausal women; 0.991, 0.917 and 0.832 g/cm2 respectively (p-value is less than 0.05). Time interval that had elapsed for active hyperthyroidism was not associated with the decrease of BMD at L1-L4, TH and FN in hyperthyroid women. CONCLUSION: The BMD of L1-L4, TH and FN in premenopausal women with hyperthyroidism were significantly lower than those of healthy premenopausal women. Therefore, overt hyperthyroidism could be associated with bone loss and may be a risk factor for the development of osteoporosis. However, time interval of active hyperthyroidism was not related to the decrease of BMD in hyperthyroid women.