Clinical Nuclear Medicine

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This month’s Editor’s Favorite is HR Kwon  and colleagues “Therapeutic Efficacy and Prediction of 18F-FDG PET/CT-Assisted Botulinum Toxin Therapy in Patients With Idiopathic Cervical Dystonia​". We have all noticed neck and back muscular FDG activity in what we presume to be muscle spasm.
The authors investigated the therapeutic efficacy of 18F-FDG PET/CT-assisted botulinum toxin (BTX) injection therapy and predictive PET findings in relation to a good response in patients with idiopathic cervical dystonia (ICD) in 78 participants. Their Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score was determined at baseline and 4 weeks after BTX injection guided by electromyography and FDG PET/CT. The number of hypermetabolic muscles, the highest SUVmax among hypermetabolic muscles, and the total SUVmax of hypermetabolic muscles were evaluated as pretreatment PET parameters. A good response was defined as a reduction rate ≥30% and a point decrease ≥15 of the TWSTRS total score.
Half of the participants showed a good response. Good responders had significantly higher baseline TWSTRS scores than poor responders (total score, P < 0.001; severity, P < 0.001; disability, P < 0.001; pain, P = 0.026).
Good responders also had significantly higher numbers of hypermetabolic muscles and BTX-injected hypermetabolic muscles (P < 0.001, both). In multivariable analysis, the baseline TWSTRS disability subscale score and the number of BTX-injected hypermetabolic muscles were significant predictors for good response (P = 0.001 and P = 0.028). The aforementioned 3 PET parameters were positively correlated with the baseline TWSTRS scores.
PET/CT also detected dystonic deep cervical muscles well.
The authors concluded that FDG PET/CT-assisted botulinum toxin injection therapy showed good therapeutic efficacy in idiopathic cervical dystonia. The numbers of hypermetabolic cervical muscles and BTX-injected hypermetabolic muscles may be helpful in predicting a good response.

Current Issue


Increased Lung Immune Metabolic Activity in COVID-19 Survivors

Rodrigues, Rosana Souza; Motta Ribeiro, Gabriel; Barreto, Miriam Menna; More

Clinical Nuclear Medicine. 47(12):1019-1025, December 2022.

Enhancing Clinical Diagnosis for Patients With Persistent Pulmonary Abnormalities After COVID-19 Infection: The Potential Benefit of 68Ga-FAPI PET/CT

Sviridenko, Anna; Boehm, Anna; di Santo, Gianpaolo; More

Clinical Nuclear Medicine. 47(12):1026-1029, December 2022.



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