title: Comparison between (18)F-FDG PET/CT and EMG Mapping for Identifying Dystonic Superficial Muscles in Primary Cervical Dystonia: Preliminary Results.
abstract: OBJECTIVE
  This study was conducted to compare (18)F-FDG PET/CT and electromyography (EMG) mapping in patients with primary cervical dystonia (PCD) to find dystonic superficial cervical muscles.
  
  
  METHODS
  Ten consecutive patients with PCD (M:F = 5:5, age 44 ± 13 years) whose dystonic posture was not relieved with conventional muscle relaxant therapy were included. Target cervical muscles for the comparison between (18)F-FDG PET/CT and EMG mapping were four representative superficial bilateral cervical muscles: splenius capitis muscle, sternocleidomstoid muscle, upper trapezius muscle, and leavator scapulae muscle. The diagnostic efficacy was compared between (18)F-FDG PET/CT and EMG mapping using physical exam and measurement of rotation angle as the gold standard.
  
  
  RESULTS
  Among 80 muscles evaluated, there were 21 (26%) dystonic superficial cervical muscles assessed with physical exam and motion analysis. The sensitivity, specificity, and accuracy for localizing dystonic muscles were 76, 92, and 88% for (18)F-FDG PET/CT, and 95, 66, and 74% for EMG mapping, respectively. The sensitivity of EMG mapping was significantly higher than that of (18)F-FDG PET/CT. In contrast, (18)F-FDG PET/CT was significantly superior to EMG mapping for specificity and accuracy.
  
  
  CONCLUSIONS
  (18)F-FDG PET/CT is more specific and accurate than EMG mapping for finding superficial dystonic cervical muscles. The high sensitivity of EMG mapping suggests that (18)F-FDG PET/CT and EMG mapping are complementary for finding dystonic superficial cervical muscles.
authors.affiliation: Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Jang
authors.affiliation: Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea.
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkawn University School of Medicine, Seoul, Korea.
authors.forename: Duk Hyun
authors.initials: DH
authors.lastname: Sung
authors.affiliation: Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkawn University School of Medicine, Seoul, Korea.
authors.forename: Kwang Hong
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea.
authors.forename: Sook Kyung
authors.initials: SK
authors.lastname: Cho
authors.affiliation: Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea.
authors.forename: Jang
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea.
authors.forename: Kyung-Han
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea.
authors.forename: Byung-Tae
authors.initials: BT
authors.lastname: Kim
keywords: 18F-FDG; Electromyography; PET/CT; Primary cervical dystonia; Spasmodic torticollis