Characterization of [ 18 F]-FDG uptake by hybrid PET-MRI in osteoarthritis of the hip

[ ^18F ]-FDG tracer uptake is a potential PET marker of musculoskeletal inflammation, but its biodistribution in osteoarthritis (OA) and colocalization with morphological changes are not well studied. We characterized [ ^18F ]-FDG tracer uptake within different areas of OA joint damage in the hip identified on simultaneously acquired structural MRI scans. Twenty patients (mean age = 67 years) were scanned on a 3T hybrid PET-MR system with time-of-flight PET and with T2 STIR (short TI inversion recovery) MRI. An experienced radiologist identified 7 subchondral cysts and 10 areas of bone marrow lesions (BMLs) on the MR images. Mean standard uptake value (SUV _mean ) was highest in joint fluid, which may reflect increased tracer diffusion or high glucose metabolism due to inflammation. SUV _mean was also elevated in subchondral cysts and BMLs relative to SUV in normal regions of the femoral head. Our observations enable improved understanding of [ ¹⁸ F]-FDG uptake in normal and diseased joint tissue.

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