18F-NaF PET/CT identifies muscular and subcutaneous calcifications in both dermatomyositis- and systemic sclerosis-related calcinosis

BackgroundCalcinosis is a morbid complication of dermatomyositis (DM) and systemic sclerosis (SSc) with no effective pharmacologic treatment or validated whole-body assessment modality. 18F-NaF PET/CT may help to quantify and characterize calcinosis.MethodsIn this pilot study, we enrolled three adul...

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Main Authors: Carrie Richardson, Mehrbod S. Javadi, Ami A. Shah, Caoilfhionn Connolly, Lilja B. Solnes, Fredrick M. Wigley, Laura K. Hummers, Lisa Christopher-Stine
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Nuclear Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fnume.2025.1593825/full
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author Carrie Richardson
Carrie Richardson
Mehrbod S. Javadi
Ami A. Shah
Caoilfhionn Connolly
Lilja B. Solnes
Fredrick M. Wigley
Laura K. Hummers
Lisa Christopher-Stine
author_facet Carrie Richardson
Carrie Richardson
Mehrbod S. Javadi
Ami A. Shah
Caoilfhionn Connolly
Lilja B. Solnes
Fredrick M. Wigley
Laura K. Hummers
Lisa Christopher-Stine
author_sort Carrie Richardson
collection DOAJ
description BackgroundCalcinosis is a morbid complication of dermatomyositis (DM) and systemic sclerosis (SSc) with no effective pharmacologic treatment or validated whole-body assessment modality. 18F-NaF PET/CT may help to quantify and characterize calcinosis.MethodsIn this pilot study, we enrolled three adults with DM and three with SSc, all with new calcinosis deposits. Each underwent 18F-NaF PET/CT and clinical examination with semi-quantitative scoring of calcinosis. We described the 18F-NaF PET/CT findings and compared these to CT imaging alone as well as to clinical examination.ResultsCalcinosis was noted on 18F-NaF PET/CT in the subcutaneous tissue in all patients and the muscle in three patients, including two with SSc. The average semi-quantitative score was 23.5 by 18F-NaF PET/CT and 20 by clinical exam. Wilcoxon signed rank test indicated greater scores by 18F-NaF PET/CT than by clinical exam (p = 0.0264). 18F-NaF uptake varied among calcinosis deposits and occurred without corresponding calcifications on CT.Conclusions18F-NaF PET/CT appears to be a sensitive method of detecting and characterizing calcinosis that provides both quantitative and qualitative data beyond what can be obtained by physical examination or CT alone. 18F-NaF uptake occurs in muscle in both SSc and DM, suggesting the possibility that myositis may be driving calcinosis in a subset of patients with SSc.
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spelling doaj-art-e80edbd7409e4fe7ac7db08fbf14bfc92025-08-20T02:34:51ZengFrontiers Media S.A.Frontiers in Nuclear Medicine2673-88802025-05-01510.3389/fnume.2025.1593825159382518F-NaF PET/CT identifies muscular and subcutaneous calcifications in both dermatomyositis- and systemic sclerosis-related calcinosisCarrie Richardson0Carrie Richardson1Mehrbod S. Javadi2Ami A. Shah3Caoilfhionn Connolly4Lilja B. Solnes5Fredrick M. Wigley6Laura K. Hummers7Lisa Christopher-Stine8Division of Rheumatology, Johns Hopkins University, Baltimore, MD, United StatesDivision of Rheumatology, Northwestern University, Chicago, IL, United StatesDepartment of Radiology, Johns Hopkins University, Baltimore, MD, United StatesDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, United StatesDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, United StatesDepartment of Radiology, Johns Hopkins University, Baltimore, MD, United StatesDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, United StatesDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, United StatesDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, United StatesBackgroundCalcinosis is a morbid complication of dermatomyositis (DM) and systemic sclerosis (SSc) with no effective pharmacologic treatment or validated whole-body assessment modality. 18F-NaF PET/CT may help to quantify and characterize calcinosis.MethodsIn this pilot study, we enrolled three adults with DM and three with SSc, all with new calcinosis deposits. Each underwent 18F-NaF PET/CT and clinical examination with semi-quantitative scoring of calcinosis. We described the 18F-NaF PET/CT findings and compared these to CT imaging alone as well as to clinical examination.ResultsCalcinosis was noted on 18F-NaF PET/CT in the subcutaneous tissue in all patients and the muscle in three patients, including two with SSc. The average semi-quantitative score was 23.5 by 18F-NaF PET/CT and 20 by clinical exam. Wilcoxon signed rank test indicated greater scores by 18F-NaF PET/CT than by clinical exam (p = 0.0264). 18F-NaF uptake varied among calcinosis deposits and occurred without corresponding calcifications on CT.Conclusions18F-NaF PET/CT appears to be a sensitive method of detecting and characterizing calcinosis that provides both quantitative and qualitative data beyond what can be obtained by physical examination or CT alone. 18F-NaF uptake occurs in muscle in both SSc and DM, suggesting the possibility that myositis may be driving calcinosis in a subset of patients with SSc.https://www.frontiersin.org/articles/10.3389/fnume.2025.1593825/fullcalcinosisscleroderma (or systemic sclerosis)dermatomyositis18F-NaF PET/CTimaging
spellingShingle Carrie Richardson
Carrie Richardson
Mehrbod S. Javadi
Ami A. Shah
Caoilfhionn Connolly
Lilja B. Solnes
Fredrick M. Wigley
Laura K. Hummers
Lisa Christopher-Stine
18F-NaF PET/CT identifies muscular and subcutaneous calcifications in both dermatomyositis- and systemic sclerosis-related calcinosis
Frontiers in Nuclear Medicine
calcinosis
scleroderma (or systemic sclerosis)
dermatomyositis
18F-NaF PET/CT
imaging
title 18F-NaF PET/CT identifies muscular and subcutaneous calcifications in both dermatomyositis- and systemic sclerosis-related calcinosis
title_full 18F-NaF PET/CT identifies muscular and subcutaneous calcifications in both dermatomyositis- and systemic sclerosis-related calcinosis
title_fullStr 18F-NaF PET/CT identifies muscular and subcutaneous calcifications in both dermatomyositis- and systemic sclerosis-related calcinosis
title_full_unstemmed 18F-NaF PET/CT identifies muscular and subcutaneous calcifications in both dermatomyositis- and systemic sclerosis-related calcinosis
title_short 18F-NaF PET/CT identifies muscular and subcutaneous calcifications in both dermatomyositis- and systemic sclerosis-related calcinosis
title_sort 18f naf pet ct identifies muscular and subcutaneous calcifications in both dermatomyositis and systemic sclerosis related calcinosis
topic calcinosis
scleroderma (or systemic sclerosis)
dermatomyositis
18F-NaF PET/CT
imaging
url https://www.frontiersin.org/articles/10.3389/fnume.2025.1593825/full
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