18F-FDG PET/CT can differentiate vertebral metastases from Schmorl's nodes by distribution characteristics of the18F-FDG.
BACKGROUND
Differentiation of vertebral metastases from Schmorl's nodes, especially with fluorine-18-fluorodeoxyglucose (18F-FDG) uptake, is very important for the appropriate management of these patients in case they have malignancy. We aimed to evaluate the value of18F-FDG positron emission tomography/computed tomography (PET/CT) in differentiating vertebral metastases from Schmorl's nodes with18F-FDG uptake.


METHODS
Fourteen patients with malignancy underwent18F-FDG PET/CT, which showed abnormal18F-FDG uptake in 19 Schmorl's nodes. Twenty one patients with vertebral metastases underwent18F-FDG PET/CT, which showed abnormal18F-FDG uptake in 28 vertebral metastatic lesions. All these Schmorl's nodes and vertebral metastases were confirmed by pathology or by follow-up. The18F-FDG PET/CT were retrospectively analyzed, including maximum standardized uptake value (SUVmax), the distribution characteristic of18F-FDG and the size of these lesions in PET and CT.


RESULTS
The mean value of SUVmax of Schmorl's nodes with18F-FDG uptake were 5.7±2.8, while the mean value of SUVmax of vertebral metastases were 6.6±3.2. There were no significant differences in the SUVmax between Schmorl's nodes and vertebral metastases. However, the18F-FDG distribution in Schmorl's nodes and vertebral metastases showed some differences. The18F-FDG uptake in the bordeline area surrounding the nucleus pulposus was highter in Schmorl's nodes. The size of Schmorl's nodes on PET was significantly smaller than that on CT. The size of vertebral metastases on PET was larger or similar with that on CT.


CONCLUSIONS
Although the SUVmax in the Schmorl's nodes and vertebral metastases was similar, the18F-FDG distribution characteristic in PET/CT can help differentiating the vertebral metastases from Schmorl's.
Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng district, Beijing, 100050, People's Republic of China. 13681221974@163.com, 13121275863@163.com.
Zhengming
Z
Wang
Daqing
D
Ma
Jigang
J
Yang
D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging* / Q000378:metabolism; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000556:secondary*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18