Clinical impact of (18)F-FDG PET/CT on the management and diagnosis of infectious spondylitis.
OBJECTIVE
The aim of this study was to evaluate the impact of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) on the management of patients with infectious spondylitis.


METHODS
Twenty-nine patients with infectious spondylitis (9 with tuberculous spondylitis and 20 with pyogenic spondylitis) who had undergone an (18)F-FDG PET/CT examination were retrospectively evaluated; 42 lesions were detected. A useful impact on the clinical management of infection therapy (start or longer duration of antibiotic therapy, or surgical intervention, etc) was defined as a strong impact, whereas gaining new information not affecting the clinical management of infection therapy from (18)F-FDG PET/CT was defined as a weak impact. No impact was defined as not obtaining any new information influencing infection therapy.


RESULTS
(18)F-FDG PET/CT had a strong impact on the clinical management of 52% (15 of 29) of the patients. (18)F-FDG PET/CT detected 10 cases of spondylitis and one artificial graft infection that the clinician had not recognized, and the therapeutic period was extended in these patients. In five patients with tuberculous spondylitis, the (18)F-FDG PET/CT images were used to decide the biopsy sites in three patients and to determine which lesions required surgery in two patients.


CONCLUSIONS
(18)F-FDG PET/CT is useful for detecting infectious spondylitis.
Department of Nuclear Medicine, Saitama Medical University International Medical Center, Hidaka City, Saitama Prefecture, Japan. itoukimiteru@yahoo.co.jp
Kimiteru
K
Ito
Kazuo
K
Kubota
Miyako
M
Morooka
Kanehiro
K
Hasuo
Hirofumi
H
Kuroki
Akio
A
Mimori
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D013166:Spondylitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18