Differentiation of Tuberculous and Pyogenic Spondylitis Using Double Phase F-18 FDG PET

Abstract

To assess the usefulness of double phase F-18 FDG PET in pyogenic spondylitis (PS) and tuberculous spondylitis (TS). Also, to investigate whether double phase F-18 FDG PET could improve the diagnostic accuracy for discrimination of PS from TS. Methods: Double phase F-18 FDG PET/CT was performed in a consecutive 23 patients (9 men, 14 women; mean age, 58.5±17.9 years, range, 19~81 years) suspected having spondylitis. PET/CT imaging was performed 60 and 120 minutes after injection of F-18 FDG.. Results: The SUVmax1 of TS and PS showed no statistical differences (TS, 4.53 1.77; PS, 4.5 1.9, p=0.9515). The SUVmax2 also showed no statistical differences between two groups (TS, 5.17 1.95; PS, 5.3 2.21, p=0.9321). The mean SUV of early and delayed F-18 FDG PET images revealed no statistical differences between TS and PS. The % SUVmax and % SUVmean have no statistical differences between TS and PS (% SUVmax, TS, 15.07 6.57%, PS, 18.79 10.48%, p=0.5109; % SUVmean, TS, 16.49 9.1%, PS, 16.88 6.72%, p=0.6524). Also, none of these quantitative indices could differentiate the TS from PS. Furthermore, none of these quantitative indices could predict the presence of TS. Conclusion: Based on the presented data, the quantitative indices of double phase F-18 FDG PET could not differentiate TS from PS despite of high sensitivity for the detection of spondylitis of F-18 FDG PET.