title: 18F-fluorodeoxyglucose-PET for patients with suspected spondylitis showing Modic change.
abstract: METHODS
  Prospective cohort study.
  
  
  OBJECTIVE
  To examine the utility of 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) to diagnose pyogenic spondylitis in patients showing Modic change.
  
  
  BACKGROUND
  Vertebral bone marrow infection may appear as Modic type 1 signal on magnetic resonance imaging, so it is difficult to distinguish between common Modic change and infection. In the current study, we aimed to examine the utility of 18F-FDG-PET to diagnose pyogenic spondylitis in patients showing Modic change.
  
  
  METHODS
  In a prospective assessment of 312 patients showing low back pain, 18 patients were suspected of having pyogenic vertebral osteomyelitis because of their symptoms, biopsy results, blood analysis, x-ray examination, magnetic resonance imaging, and FDG-PET during a 1-year follow-up.
  
  
  RESULTS
  Observers ultimately diagnosed 11 patients with pyogenic spondylitis (group 1 observers). FDG-PET evaluation by 2 radiologists (group 2 observers) showed isotope accumulation in the lumbar spine in 11 patients, and no accumulation in 7 patients. The evaluation by group 1 observers, who did not see the FDG-PET findings, was compared with the evaluation by group 2 observers. No patients were evaluated differently by group 1 and group 2 observers.
  
  
  CONCLUSIONS
  In conclusion, the rate of detecting spondylodiscitis infection was very high if FDG-PET was additionally used. FDG-PET is recommended to distinguish between common Modic change and spinal infection.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. sohtori@faculty.chiba-u.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.forename: Munetaka
authors.initials: M
authors.lastname: Suzuki
authors.forename: Takana
authors.initials: T
authors.lastname: Koshi
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamashita
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.forename: Yawara
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kuniyoshi
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Ochiai
authors.forename: Shunji
authors.initials: S
authors.lastname: Kishida
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Aoki
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Gen
authors.initials: G
authors.lastname: Arai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyagi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kamoda
authors.forename: Miyako
authors.initials: M
authors.lastname: Suzuki
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakamura
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003937:Diagnosis, Differential; D015299:Discitis / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013166:Spondylitis / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D019788:Fluorodeoxyglucose F18