Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography imaging in pyogenic and tuberculous spondylitis: preliminary study.
OBJECTIVE
The purpose of this study was to compare the effectiveness of positron emission tomography (PET)/computed tomography (CT) in distinguishing between tuberculous and pyogenic spondylitis with that of magnetic resonance imaging (MRI).


METHODS
Twenty-two consecutive patients confirmed to have tuberculous or pyogenic spondylitis were examined with both MRI and dual-time point PET/CT. The serum C-reactive protein (CRP) level was measured. The early and delayed PET/CT data were analyzed using the standardized uptake value (SUV). The radiologists scored the MRI findings and differentiated between tuberculous and pyogenic spondylitis. Each MRI result and CRP value was compared with the SUVs of PET/CT.


RESULTS
The reviewers identified tuberculous spondylitis (n = 11) on MRI, with a sensitivity, specificity, and positive predictive values of 90%, 100%, and 100%, respectively. For pyogenic spondylitis (n = 11), the corresponding values were 100%, 90%, and 92%, respectively. There was a significant difference in the maximum SUVs of the early phase between tuberculous and pyogenic spondylitis (P = 0.028). Magnetic resonance imaging was superior to PET/CT in differentiating between tuberculous and pyogenic spondylitis (P = 0.043). A comparison of the maximum SUVs of the early phase and CRP values revealed a correlation coefficient of 0.581 (P = 0.006).


CONCLUSIONS
The maximum SUVs of early-phase PET/CT may be complementary to MRI for differentiating pyogenic and tuberculous spondylitis and reflecting the activity of infectious spondylitis.
Lee
In Sook
IS
Medical Research Institute, Pusan National University, Busan, Republic of Korea.
Lee
Jung Sub
JS
Kim
Seong-Jang
SJ
Jun
Sungmin
S
Suh
Keun Tak
KT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013131:Spine / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D013166:Spondylitis / Q000000981:diagnostic imaging* / Q000382:microbiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult
D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002097:C-Reactive Protein