title: Higher fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) uptake in tuberculous compared to bacterial spondylodiscitis.
abstract: BACKGROUND
  Tuberculous spondylodiscitis can be difficult to diagnose because of its nonspecific symptoms and the similarities with non-tubercular forms of spinal infection. Fluorine-18-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET-CT) is increasingly used for the diagnosis and monitoring of tubercular diseases.
  
  
  METHODS
  Retrospective, case-control study comparing tuberculous spondylodiscitis with biopsy-confirmed pyogenic spondylodiscitis in the period 2010-2012.
  
  
  RESULTS
  Ten cases of tuberculous spondylodiscitis and 20 controls were included. Compared to pyogenic, tuberculous spondylodiscitis was more frequent in younger patients (P = 0.01) and was more often associated with thoraco-lumbar tract lesions (P = 0.01) and multiple vertebral involvement (P = 0.01). Significantly higher maximum standardized uptake values (SUV) at FDG-PET were displayed by tuberculous spondylodiscitis compared to controls (12.4 vs. 7.3, P = 0.003). SUV levels above 8 showed the highest value of specificity (0.80). Mean SUV reduction of 48% was detected for tuberculous spondylodiscitis at 1-month follow-up.
  
  
  CONCLUSIONS
  Higher SUV levels at FDG-PET were detected in tuberculous compared with pyogenic spondylodiscitis. PET-CT use appeared useful in the disease follow-up after treatment initiation.
authors.affiliation: Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 50, Colugna Street, Udine, 33100, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
authors.affiliation: Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 50, Colugna Street, Udine, 33100, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Merelli
authors.affiliation: Microbiology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy.
authors.forename: Fernando
authors.initials: F
authors.lastname: Di Gregorio
authors.affiliation: Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 50, Colugna Street, Udine, 33100, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Della Siega
authors.affiliation: Radiology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Screm
authors.affiliation: Radiology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Scarparo
authors.affiliation: Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 50, Colugna Street, Udine, 33100, Italy. elda.righi@libero.it.
authors.forename: Elda
authors.initials: E
authors.lastname: Righi
mesh_terms: D001424:Bacterial Infections / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D015299:Discitis / Q000000981:diagnostic imaging* / Q000382:microbiology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Fluorine-18-fluorodeoxyglucose positron emission tomography; Pyogenic spondylodiscitis; Spinal tuberculosis; Standardized uptake values