The Role of 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) in the Diagnosis and Evaluation of Spondylodiscitis

IF 4.6 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine Pub Date : 2024-05-01 DOI:10.1053/j.semnuclmed.2024.04.001

Diana Paez MD , Francesco Giammarile MD , Anita Brink MD , Osvaldo García-Pérez MD , Enrique Estrada-Lobato MD, MSc

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引用次数: 0

Abstract

Spondylodiscitis, characterized by inflammation of the intervertebral disc and adjacent vertebral bodies, presents a diagnostic challenge due to its nonspecific clinical manifestations and variable imaging findings.

This review examines the role of PET-CT with FDG, in the evaluation of spondylodiscitis, focusing on its utility in diagnosis, assessment of disease extent, treatment response monitoring, and prognostication.

FDG PET-CT, by combining metabolic and anatomical imaging modalities, offers superior sensitivity and specificity compared to conventional imaging techniques in detecting infectious foci, distinguishing between infection and post-treatment changes, and identifying occult sources of infection. Additionally, FDG PET-CT facilitates the localization of infection, aiding in targeted biopsy and guiding surgical intervention. Moreover, quantitative PET parameters, such as standardized uptake values (SUVs), hold promise for predicting treatment response and prognosis. Despite its advantages, FDG PET-CT has limitations, including false-positive results in the setting of inflammation and limited availability in resource-constrained settings.

Collaborative efforts between radiologists, nuclear medicine specialists, infectious disease specialists, and spine surgeons are essential to optimize the role of FDG PET-CT in the multidisciplinary management of spondylodiscitis. Further research is warranted to elucidate the cost-effectiveness and clinical impact of FDG PET-CT in this challenging clinical entity.

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18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）在诊断和评估脊柱盘炎中的作用。

脊椎盘炎是以椎间盘和邻近椎体的炎症为特征的疾病，由于其非特异性的临床表现和多变的影像学结果，给诊断带来了挑战。本综述探讨了 FDG PET-CT 在脊柱盘炎评估中的作用，重点关注其在诊断、疾病程度评估、治疗反应监测和预后方面的实用性。FDG PET-CT 结合了代谢和解剖成像模式，与传统成像技术相比，在检测感染灶、区分感染和治疗后变化以及识别隐性感染源方面具有更高的灵敏度和特异性。此外，FDG PET-CT 还有助于对感染进行定位，帮助进行有针对性的活检和指导手术干预。此外，标准化摄取值（SUV）等定量 PET 参数有望预测治疗反应和预后。尽管 FDG PET-CT 有其优势，但也有其局限性，包括在炎症情况下会出现假阳性结果，以及在资源有限的情况下可用性有限。放射科医生、核医学专家、传染病专家和脊柱外科医生之间的合作对于优化 FDG PET-CT 在脊柱盘炎症多学科治疗中的作用至关重要。有必要开展进一步研究，以阐明 FDG PET-CT 在这一具有挑战性的临床实体中的成本效益和临床影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in nuclear medicine 医学-核医学

CiteScore

9.80

自引率

6.10%

发文量

审稿时长

14 days

期刊介绍： Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.