title: Pattern of 18F-FDG uptake in the spinal cord in patients with non-central nervous system malignancy.
abstract: METHODS
  Retrospective review.
  
  
  OBJECTIVE
  To (1) propose a standard method to quantitate 2-deoxy-2-[18F]-fluoro-D-glucose (18F-FDG) uptake in the spinal cord and (2) use this methodology to retrospectively characterize the pattern of uptake within the entire spinal cord using whole-body positron emission tomography/computed tomography (PET/CT) imaging.
  
  
  BACKGROUND
  A physiologic understanding of glucose metabolism within the spinal cord may provide insight regarding infectious, inflammatory, vascular, and neoplastic spinal cord diseases.
  
  
  METHODS
  Institutional review board approval was obtained. A total of 131 consecutive whole-body PET/CT studies from July to August 2004 were reviewed, and using exclusionary criteria of: (1) severe spinal arthropathy or curvature, (2) motion artifact, (3) canal hardware, (4) spinal tumor, and (5) marrow hyperplasia, 92 studies of neurologically intact patients (49 men and 43 women) were selected for a retrospective review of spinal cord 18F-FDG activity. The transaxial CT was used to define the canal and circular regions of interests were placed within the canal at the level of the vertebral body midpoint from C1 to L3. Region of interest total count, area, and maximum standardized uptake value (SUVmax) were recorded. Measurements at L5 served as an internal control. For comparative analysis, the cord-to-background (CTB) ratio was defined as spinal cord SUVmax to L5 SUVmax.
  
  
  RESULTS
  Mean CTB decreased along each spinal level from cranial to caudal (P < 0.001). Significant relative increases were observed at the T11-T12 vertebral body levels (P < 0.001). Although insignificant, a relative increase was observed at C4. No significant interactions of age or sex on CTB were observed.
  
  
  CONCLUSIONS
  The pattern of 18F-FDG uptake within the spinal cord, observed in patients with non-central nervous system malignancy, may be helpful in understanding glucose physiology of spinal cord diseases and warrants further research.
authors.affiliation: Department of Radiology, Stanford University Medical Center, Palo Alto, CA 94305, USA.
authors.forename: Bao H
authors.initials: BH
authors.lastname: Do
authors.forename: Carina
authors.initials: C
authors.lastname: Mari
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Tseng
authors.forename: Andrew
authors.initials: A
authors.lastname: Quon
authors.forename: Jarrett
authors.initials: J
authors.lastname: Rosenberg
authors.forename: Sandip
authors.initials: S
authors.lastname: Biswal
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002140:California; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009369:Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000378:metabolism; D012189:Retrospective Studies; D013116:Spinal Cord / Q000000981:diagnostic imaging* / Q000378:metabolism; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18