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Comparison between (18)F-FDG PET/CT and EMG Mapping for Identifying Dystonic Superficial Muscles in Primary Cervical
Su Jin Jang1, Joon Young Choi2, Duk Hyun Sung3
1Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Korea.
Purpose:
This study was conducted to compare (18)F-FDG PET/CT and electromyography (EMG) mapping in patients with primary cervical dystonia (PCD) to find dystonic superficial cervical muscles.
Methods:
Ten consecutive patients with PCD (M:F = 5:5, age 44 ± 13 years) whose dystonic posture was not relieved with conventional muscle relaxant therapy were included. Target cervical muscles for the comparison between (18)F-FDG PET/CT and EMG mapping were four representative superficial bilateral cervical muscles: splenius capitis muscle, sternocleidomstoid muscle, upper trapezius muscle, and leavator scapulae muscle. The diagnostic efficacy was compared between (18)F-FDG PET/CT and EMG mapping using physical exam and measurement of rotation angle as the gold standard.
Results:
Among 80 muscles evaluated, there were 21 (26%) dystonic superficial cervical muscles assessed with physical exam and motion analysis. The sensitivity, specificity, and accuracy for localizing dystonic muscles were 76, 92, and 88% for (18)F-FDG PET/CT, and 95, 66, and 74% for EMG mapping, respectively. The sensitivity of EMG mapping was significantly higher than that of (18)F-FDG PET/CT. In contrast, (18)F-FDG PET/CT was significantly superior to EMG mapping for specificity and accuracy.
Conclusions:
(18)F-FDG PET/CT is more specific and accurate than EMG mapping for finding superficial dystonic cervical muscles. The high sensitivity of EMG mapping suggests that (18)F-FDG PET/CT and EMG mapping are complementary for finding dystonic superficial cervical muscles.
