Universität zu Köln

Hungenbach, Stefan, Delank, Karl-Stefan, Dietlein, Markus, Eysel, Peer, Drzezga, Alexander and Schmidt, Matthias C. (2013). F-18-fluorodeoxyglucose uptake pattern in patients with suspected spondylodiscitis. Nucl. Med. Commun., 34 (11). S. 1068 - 1075. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 0143-3636

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Abstract

BackgroundInfections of the spine are rare and often discovered late, but they can have a severe outcome with hospital case fatality rates of up to 17%. Efficient and early diagnosis is important, because early diagnosis and therapy improve outcome. The aim of the current study was to evaluate the clinical value of F-18-fluorodeoxyglucose (F-18-FDG) uptake pattern in PET as a diagnostic modality for the detection of spondylodiscitis.Materials and methods(18)F-FDG-PET examinations of the spine were performed in 42 patients with suspected spondylodiscitis. Of these 42 patients, 13 had already undergone spinal surgery in the past, making initial definition of the test group difficult and complex. Qualitative analysis was based on F-18-FDG uptake patterns, and quantitative maximal standard uptake value measurements were ascertained. PET findings were verified by comparing them with combined information from intraoperative findings, blood results, microbiological investigations, histopathology, and clinical examination.ResultsEvidence of spondylodiscitis was correctly determined in 95% of patients and absence of spondylodiscitis in 86% of patients using F-18-FDG-PET. The detection of spondylodiscitis by F-18-FDG-PET had a sensitivity of 86% and a specificity of 95%. Three patients had false-negative and one patient a false-positive finding on F-18-FDG-PET.ConclusionThe application of F-18-FDG uptake patterns in F-18-FDG-PET helps to predict or exclude spondylodiscitis. Differentiation between inflammatory and degenerative changes in the vertebral body endplates is possible. Owing to the high specificity of this method, a negative PET result in the setting of a diagnostically unclear case diminishes the need for surgical intervention. F-18-FDG-PET is therefore an important tool in inflammation imaging and can be used in the diagnostic cascade of difficult cases with suspected spondylodiscitis. In contrast, a positive PET result does not always clearly establish the cause of increased F-18-FDG uptake. (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hungenbach, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Delank, Karl-Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Dietlein, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, Peer UNSPECIFIED UNSPECIFIED UNSPECIFIED Drzezga, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Matthias C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-473192
DOI:	10.1097/MNM.0b013e328365abec
Journal or Publication Title:	Nucl. Med. Commun.
Volume:	34
Number:	11
Page Range:	S. 1068 - 1075
Date:	2013
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	0143-3636
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITRON-EMISSION-TOMOGRAPHY; CHRONIC OSTEOMYELITIS; NUCLEAR-MEDICINE; FDG-PET; DIAGNOSIS; SPONDYLITIS; INFECTIONS Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47319