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Clinical impact of 18F-FDG PET/CT on the management and diagnosis of infectious spondylitis

Ito, Kimiterua; Kubota, Kazuob; Morooka, Miyakob; Hasuo, Kanehirob; Kuroki, Hirofumic; Mimori, Akiod

Nuclear Medicine Communications: August 2010 - Volume 31 - Issue 8 - pp 691-698
doi: 10.1097/MNM.0b013e32833bb25d
Original Articles

Objective: The aim of this study was to evaluate the impact of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) on the management of patients with infectious spondylitis.

Materials and methods: Twenty-nine patients with infectious spondylitis (9 with tuberculous spondylitis and 20 with pyogenic spondylitis) who had undergone an 18F-FDG PET/CT examination were retrospectively evaluated; 42 lesions were detected. A useful impact on the clinical management of infection therapy (start or longer duration of antibiotic therapy, or surgical intervention, etc) was defined as a strong impact, whereas gaining new information not affecting the clinical management of infection therapy from 18F-FDG PET/CT was defined as a weak impact. No impact was defined as not obtaining any new information influencing infection therapy.

Results: 18F-FDG PET/CT had a strong impact on the clinical management of 52% (15 of 29) of the patients. 18F-FDG PET/CT detected 10 cases of spondylitis and one artificial graft infection that the clinician had not recognized, and the therapeutic period was extended in these patients. In five patients with tuberculous spondylitis, the 18F-FDG PET/CT images were used to decide the biopsy sites in three patients and to determine which lesions required surgery in two patients.

Conclusion: 18F-FDG PET/CT is useful for detecting infectious spondylitis.

aDepartment of Nuclear Medicine, Saitama Medical University International Medical Center

Departments of bRadiology

cOrthopedics

dDivision of Rheumatic disease, International Medical Center of Japan Toyama Hospital, Japan

Correspondence to Dr Kimiteru Ito, MD, Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-3 Yamane, Hidaka City, Saitama Prefecture, Japan

Tel: +81 42 984 4147; fax: +81 42 984 4146;

e-mail: itoukimiteru@yahoo.co.jp

Received 10 March 2010 Revised 13 April 2010 Accepted 4 May 2010

© 2010 Lippincott Williams & Wilkins, Inc.