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Clinical Significance of 3D-MRI/18F-FDG PET Fusion Imaging of Patients with Cervical Compressive Myelopathy

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Neuroprotection and Regeneration of the Spinal Cord

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Abstract

The present study was designed to evaluate the use of three-dimensional (3D)-MRI/18F-FDG PET fusion imaging to define intramedullary signal changes on MRIs and local glucose metabolic rate measured on 18F-FDG PET in relation to clinical outcome and prognosis. Quantitative analysis of intramedullary signal changes on MRIs included calculation of the signal intensity ratio (SIR). On fusion images, the maximal count at the lesion was adopted as the standardized uptake value (SUVmax). The SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopaedic Association (JOA) scoring system. The SIR on T1-weighted images (WIs), but not SIR on T2-WIs, correlated with preoperative JOA score and postoperative neurological improvement. Lesion-SUVmax correlated with SIR on T1-WIs, but not with SIR on T2-WIs, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-WIs and lesion-SUVmax with neurological improvement. Longer symptom duration correlated negatively with SIR on T1-WIs, positively with SIR on T2-WIs, and negatively with SUVmax. Our results suggest that low-intensity signal on the T1-WIs correlates with poor postoperative neurological outcome. SUVmax measured at lesions with increased signal intensity and SUVR measured on fusion MRI/PET are sensitive parameters for prediction of clinical outcome.

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Acknowledgment

 This work was supported in part by grants from the Japanese Governmental Investigation Committee on Ossification of the Spinal Ligaments (2000–2012).

Conflict of Interest  All authors declare that they have no conflict of interest.

Informed Consent  All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Faculty of Medical Sciences, Department of Orthopaedics and Rehabilitation Medicine, University of Fukui, Matsuoka Shimoaizuki 23-3, Eiheiji, Fukui, 910-1193, Japan

    Kenzo Uchida, Hideaki Nakajima, Ai Yoshida & Hisatoshi Baba

  2. Biomedical Imaging Research Center, University of Fukui, Matsuoka Shimoaizuki 23, Eiheiji, Fukui, 910-1193, Japan

    Hidehiko Okazawa

  3. Department of Radiology, Faculty of Medical Sciences, University of Fukui, Matsuoka Shimoaizuki 23, Eiheiji, Fukui, 910-1193, Japan

    Hirohiko Kimura

Authors
  1. Kenzo Uchida
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  2. Hideaki Nakajima
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  3. Hidehiko Okazawa
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  4. Hirohiko Kimura
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  5. Ai Yoshida
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  6. Hisatoshi Baba
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Corresponding author

Correspondence to Kenzo Uchida .

Editor information

Editors and Affiliations

  1. Dept of Orthop & Rehabilit Med, University of Fukui Faculty of Medical Sciences, Yoshida-gun, Fukui, Japan

    Kenzo Uchida

  2. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Tokyo, Japan

    Masaya Nakamura

  3. Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan

    Hiroshi Ozawa

  4. Department of Orthopedic Surgery, Faculty of Medicine The University of Tokushima, Tokushima, Tokushima, Japan

    Shinsuke Katoh

  5. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Tokyo, Japan

    Yoshiaki Toyama

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Uchida, K., Nakajima, H., Okazawa, H., Kimura, H., Yoshida, A., Baba, H. (2014). Clinical Significance of 3D-MRI/18F-FDG PET Fusion Imaging of Patients with Cervical Compressive Myelopathy. In: Uchida, K., Nakamura, M., Ozawa, H., Katoh, S., Toyama, Y. (eds) Neuroprotection and Regeneration of the Spinal Cord. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54502-6_29

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  • DOI: https://doi.org/10.1007/978-4-431-54502-6_29

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  • Print ISBN: 978-4-431-54501-9

  • Online ISBN: 978-4-431-54502-6

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