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18F-NaF PET Aids in Child Abuse Detection

April 15, 2010
Written by: , Filed in: Emergency Radiology, Pediatric Radiology
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Part 2 of 2

April is National Child Abuse Prevention Month, and recent work has determined how child abuse victims might be more easily and better identified. 

HealthImaging.com relates information from the April issue of Radiology and the study by Laura A. Drubach, MD, and her colleagues from the department of radiology at Children’s Hospital and Harvard Medical School in Boston. They compared baseline skeletal survey and 18F-NaF PET images  in 22 children under the age of two. The former procedure showed a total of 156 fractures among the patients, and the latter showed 200.

“PET had sensitivities of 85 percent for the detection of all fractures,” Dr. Drubach wrote. “[It had] 92 percent for the detection of thoracic fractures (ribs, sternum, clavicle and scapula), 93 percent for the detection of posterior rib fractures, and 67 percent for the detection of classic metaphysical lesions (CMLs).”

These numbers were opposed to the baseline skeletal survey sensitivities of 72 percent for all fracture detection, 68 percent for thoracic fractures, 73 percent for posterior rib fractures and 80 percent for CMLs.

Since the PET did not show as well for CMLs, other exams would still need to be done, but, also, since CMLs are “distinct injuries in infants, PET scanning shows promise as the sole global skeletal assessment tool in children older than 12 months.” And the “image contrast from the high tracer extraction with 18F-NaF PET, as well as the intrinsically high sensitivity and high spatial resolution of 18F-NaF PET technology, makes it an attractive choice for the evaluation of child abuse,” according to the article.

In a paper from emedicine, authors wrote that “skeletal injury is the most common form of [abuse] injury (excluding external soft tissue injuries). Fractures are documented in 11-55% of physically abused children. Injuries to the long bones are the result of a direct blow or, more commonly, a shear force. Shear force is generated by pulling and twisting the body or by vigorously shaking the torso with flailing of the upper and lower extremities.”

Related seminar: Emergency Radiology

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