18F-fluorodeoxyglucose uptake pattern in patients with suspected spondylodiscitis

Area of Science:

• Nuclear Medicine
• Radiology
• Infectious Disease Imaging

Background:

• Spinal infections (spondylodiscitis) are rare but can lead to severe outcomes, with high fatality rates.
• Early diagnosis and treatment are crucial for improving patient outcomes in spinal infections.

Purpose of the Study:

• To evaluate the clinical utility of F-fluorodeoxyglucose (18F-FDG) uptake patterns in Positron Emission Tomography (PET) for diagnosing spondylodiscitis.
• To assess the diagnostic accuracy of 18F-FDG PET in detecting spinal infections.

Main Methods:

• 18F-FDG PET scans were performed on 42 patients with suspected spondylodiscitis.
• Analysis included qualitative assessment of 18F-FDG uptake patterns and quantitative maximal standard uptake value measurements.
• PET findings were validated against intraoperative results, blood tests, microbiology, histopathology, and clinical examination.

Main Results:

• 18F-FDG PET correctly identified spondylodiscitis in 95% of patients and ruled it out in 86%.
• The method demonstrated a sensitivity of 86% and a specificity of 95% for detecting spondylodiscitis.
• Three false-negative and one false-positive results were observed.

Conclusions:

• 18F-FDG uptake patterns in PET scans effectively predict or exclude spondylodiscitis.
• The technique can differentiate between inflammatory and degenerative changes in vertebral endplates.
• High specificity of 18F-FDG PET reduces the need for surgery in unclear cases, establishing it as a valuable tool for inflammation imaging.