Department of Nuclear Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
Spine (Phila Pa 1976). 2009 Oct 15;34(22):2424-30. doi: 10.1097/BRS.0b013e3181b1fd33.
Prospective study.
To determine whether F-18 fluoro-deoxy-glucose positron emission tomography/computed tomography (F-18 FDG PET/CT) follow-up imaging after treatment in patients with spinal infection (SI) could provide useful prognostic information and determine the residual SI.
There are seldom data on the capability of follow-up imaging methods to predict residual disease and treatment efficacy in patients with SI.
Thirty patients with SI underwent F-18 FDG PET/CT at initial and during follow-up. From F-18 FDG PET/CT, quantitative indexes were obtained. The residual SI was determined by the presence of preoperative symptoms, hematological infection marker, and radiologic findings.
The SUVmax were significantly declined after treatment in both of residual (2.85 +/- 1.17 vs. 2.06 +/- 1.03; P < 0.0001) and nonresidual SI (4.31 +/- 2.07 vs. 1.44 +/- 0.46; P < 0.0001). The SUVmean were also decreased after treatment in both of residual (1.45 +/- 0.45 vs. 1.04 +/- 0.29; P = 0.0014) and nonresidual SI (2.09 +/- 1.03 vs. 0.81 +/- 0.25; P < 0.0001). By lesion-based analysis, when < or =43.01% of %deltaSUVmax was used as threshold value, the area under curve (AUC) was 0.879 (P = 0.0001). The sensitivity and specificity were 85.7% and 82.6%, respectively. When < or =44.12% of %deltaSUVmean was used as threshold value, AUC was 0.828 (P = 0.0001). The sensitivity and specificity were 85.7% and 68%, respectively. In patient-based analysis, when < or =46.14% of %deltaSUVmax was used as threshold value, AUC was 0.904 (P = 0.0001). The sensitivity and specificity were 100% and 76.9%, respectively. When < or =41.78% of %deltaSUVmean was used as threshold value, AUC was 0.923 (P = 0.0001). The sensitivity and specificity were 100%, 76.9%, respectively.
F-18 FDG PET/CT is useful for discrimination of residual and nonresidual SI after treatment. Among the various quantitative indexes, %deltaSUVmax is a potent predictor of residual SI in the current study.
前瞻性研究。
确定治疗后脊柱感染（SI）患者的 F-18 氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-18 FDG PET/CT）随访成像是否能提供有用的预后信息并确定残留的 SI。
关于随访成像方法在预测 SI 患者的残留疾病和治疗效果方面的能力，很少有数据。
30 例 SI 患者在初始和随访时接受 F-18 FDG PET/CT 检查。从 F-18 FDG PET/CT 中获得定量指标。残留 SI 通过术前症状、血液感染标志物和影像学发现来确定。
治疗后，残留 SI 的 SUVmax（2.85 ± 1.17 比 2.06 ± 1.03；P < 0.0001）和非残留 SI（4.31 ± 2.07 比 1.44 ± 0.46；P < 0.0001）均显著下降。治疗后残留 SI 的 SUVmean（1.45 ± 0.45 比 1.04 ± 0.29；P = 0.0014）和非残留 SI（2.09 ± 1.03 比 0.81 ± 0.25；P < 0.0001）也降低。基于病变的分析，当＜或等于 43.01%的 %deltaSUVmax 用作阈值时，曲线下面积（AUC）为 0.879（P = 0.0001）。敏感性和特异性分别为 85.7%和 82.6%。当＜或等于 44.12%的 %deltaSUVmean 用作阈值时，AUC 为 0.828（P = 0.0001）。敏感性和特异性分别为 85.7%和 68%。在患者基础分析中，当＜或等于 46.14%的 %deltaSUVmax 用作阈值时，AUC 为 0.904（P = 0.0001）。敏感性和特异性分别为 100%和 76.9%。当＜或等于 41.78%的 %deltaSUVmean 用作阈值时，AUC 为 0.923（P = 0.0001）。敏感性和特异性分别为 100%和 76.9%。
F-18 FDG PET/CT 有助于区分治疗后残留和非残留的 SI。在各种定量指标中，%deltaSUVmax 是当前研究中残留 SI 的有力预测因子。
