EANM: FDG PET/CT offers diagnostic value for spondylodiscitis

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FDG PET/CT could be useful in the diagnosis of clinically suspected spondylodiscitis in patients with persistent back pain, according to a presentation last week at the 2009 European Association of Nuclear Medicine (EANM) congress in Barcelona, Spain.

“Diagnosis of spondylodiscitis may be difficult and require multiple imaging procedures,” said lead researcher Christian Pirich, MD, from the deparment of nuclear medicine at University Hospital Salzburg, Austria.

In the study, the researchers compared the diagnostic value of FDG-PET/CT imaging with MRI in 22 patients with clinically suspected spondylodiscitis.

The conditions for patient selection included presence of back pain with extension to a specific dermatome or radicular symptoms or relapse of back pain, history of spondylodiscitis, transient or persistent fever of unknown origin and an increase of inflammation markers, equivocal imaging findings and comorbidity.

Out of 22 patients, only 11 were confirmed with spondylodiscitis by visual analysis. According to the investigators, the mean ratio of standardized uptake value was 2.5 in patients with the final diagnosis of spondylodiscitis and 1.5 in patients with degenerative vertebral changes.

FDG-PET/CT demonstrated a sensitivity of 82 percent, specificity of 100 percent and accuracy of 91 percent in detecting spondylodiscitis while the sensitivity of MRI was 67 percent, specificity was 75 percent and accuracy was 69 percent.

Based on their findings, the Austrian researchers concluded that FDG PET/CT could be used as a tool for the diagnosis of clinically suspected spondylodiscitis.