Usefulness of (18)f-fluorodeoxyglucose positron emission tomography/computed tomography in management of cervical dystonia.
OBJECTIVE
To evaluate the usefulness of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the management of cervical dystonia (CD) with botulinum toxin type A (BoNT-A) injection.


METHODS
Thirty two subjects with CD were included. A BoNT-A injection was provided either by clinically targeting method (group 1) or by (18)F-FDG PET/CT-assisted, clinically targeting method (group 2). In group 2, selection of target muscles and dosage of BoNT-A were determined according to the increased (18)F-FDG uptake, in addition to physical examination and functional anatomy. The outcomes of BoNT-A injection was compared between the two groups, in terms of the number of subjects who had reinjection before and after 6 months, the number of reinjections, the interval of reinjections, the duration to the minimal Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), the number of adverse events, the reduction rate of TWSTRS at 1-3 months and 3-6 months after injection, and the probability of reinjection-free living.


RESULTS
The number of subjects who had reinjection within 6 months was significantly lower in group 2 than in group 1 (10 in group 1 vs. 3 in group 2). The reduction rate of TWSTRS after 3-6 months (37.8±15.7% of group 1 vs. 63.3±28.0% of group 2) and the probability of reinjection-free living were significantly higher in group 2 than in group 1.


CONCLUSIONS
These findings suggest that (18)F-FDG PET/CT study could be useful in management of CD in terms of the identification of dystonic muscles if there is an increase in the (18)F-FDG uptake in the cervical muscle of the images.
The Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon 443-749, Korea.
Han Byul
HB
Lee
Young-Sil
YS
An
Hyun Young
HY
Lee
Jee Hyun
JH
Hwang
Hyun Jung
HJ
Lee
Kil Yong
KY
Jeong
Jong Woo
JW
Kim
Shin-Young
SY
Yim
18F-Fluorodeoxyglucose; Botulinum toxin; Cervical dystonia; Positron emission tomography