Localization of dystonic muscles with 18F-FDG PET/CT in idiopathic cervical dystonia.
The purpose of this study was to investigate whether (18)F-FDG PET/CT is useful for localizing dystonic cervical muscles in patients with idiopathic cervical dystonia (ICD) by comparing disease severity before and disease severity after botulinum toxin (BT) injection into hypermetabolic muscles.


METHODS
Six patients with ICD underwent (18)F-FDG PET/CT. Dystonic muscles suitable for BT injection therapy were defined as those showing diffusely increased (18)F-FDG uptake.


RESULTS
Hypermetabolic cervical muscles were identified in all 6 patients. In 2 patients who underwent PET/CT both in a supine position and in a sitting position during (18)F-FDG uptake, abnormal hypermetabolic muscles were observed by PET/CT only when patients were in the sitting position with their heads and necks in the adopted abnormal involuntary posture. Symptoms were significantly improved in 4 patients who underwent BT injection therapy guided by PET/CT and who were clinically monitored.


CONCLUSIONS
(18)F-FDG PET/CT is potentially useful for identifying dystonic cervical muscles for BT therapy in patients with ICD.
Sung
Duk Hyun
DH
Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Choi
Joon Young
JY
Kim
Du-Hwan
DH
Kim
Eun-Sang
ES
Son
Young-Ik
YI
Cho
Young-Seok
YS
Lee
Su Jin
SJ
Lee
Kyung-Han
KH
Kim
Byung-Tae
BT
D000328:Adult; D001905:Botulinum Toxins / Q000627:therapeutic use; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011187:Posture; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D014103:Torticollis / Q000000981:diagnostic imaging* / Q000188:drug therapy
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D001905:Botulinum Toxins