Imaging of Spondylodiscitis: An Update

Area of Science:

• Radiology
• Nuclear Medicine
• Infectious Disease Imaging

Background:

• Spondylodiscitis, an infection of the spine, presents diagnostic challenges due to nonspecific symptoms.
• Prompt diagnosis and treatment are vital to mitigate high morbidity and mortality rates.

Purpose of the Study:

• To review and compare imaging modalities for diagnosing spondylodiscitis.
• To highlight the advantages of ¹⁸F-FDG imaging over other nuclear medicine techniques.

Main Methods:

• Review of magnetic resonance imaging (MRI) and various radionuclide imaging techniques.
• Comparison of bone scintigraphy, Gallium-67 citrate imaging, and ¹⁸F-FDG imaging for spondylodiscitis diagnosis.

Main Results:

• MRI with contrast is the imaging modality of choice but less effective for monitoring treatment response.
• ¹⁸F-FDG imaging demonstrates high sensitivity, a high negative predictive value, and effectively differentiates infectious from degenerative changes.
• ¹⁸F-FDG outperformed bone and Gallium-67 imaging in comparative studies and shows potential for treatment response monitoring.

Conclusions:

• ¹⁸F-FDG imaging is the radionuclide test of choice for spondylodiscitis diagnosis due to its speed, accuracy, and ability to monitor treatment.
• While MRI is primary, ¹⁸F-FDG offers a valuable alternative and complementary role, especially when MRI is contraindicated or for treatment evaluation.