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Physiologically intense FDG uptake of distal spinal cord on total-body PET/CT

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Abstract

Objective

Physiologically mild-to-moderate FDG uptake of the spinal cord was reported. However, we noticed intense FDG uptake of distal spinal cord in several patients without definite spinal cord lesions on total-body PET/CT. Thus, this study aimed to investigate the frequency, pattern, intensity, and associations of FDG uptake in such cases on total-body PET/CT.

Methods

The clinical characteristics of age, gender, body mass index (BMI), lower extremity symptom, diabetes, and fasting blood glucose level, and total-body FDG PET/CT metabolic parameters of maximum standard uptake value (SUVmax), SUVmax of lean body mass (SUVlbm), and SUVmax of body surface area (SUVbsa), were retrospectively analyzed in 527 patients without definite spinal cord lesions. Intense FDG uptake was defined as greater than liver glucometabolism on visual analysis, and T5 cord was selected as cord background.

Results

Intense FDG uptake of distal spinal cord was observed in 87 out of 527 patients (16.5%) and involved with 2–3 vertebral segments including T11–T12 in 33 cases (38.0%), T12–L1 in 29 (33.3%), and T11–L1 in 25 (28.7%). No lesions were demonstrated on follow-up physical examinations, MRI or contrast-enhanced CT in these 87 cases with intense FDG accumulation in the distal spinal cord. The median SUVmax, SUVlbm, and SUVbsa of distal spinal cord with intense FDG uptake were 3.8 (2.7–5.5), 2.9 (2.2–4.3), and 1.0 (0.7–1.6), respectively. Significant differences in SUVmax, SUVlbm, and SUVbsa of distal cord and cord background were found between the groups with and without intense FDG uptake (P < 0.05). Moreover, significant differences in ratios of distal spinal cord-to-cord background, to mediastinal blood pool, and to liver were observed between two groups (P < 0.05). Intense FDG uptake of distal cord was associated with age, diabetic status, and blood glucose level.

Conclusions

Intense FDG uptake of distal spinal cord on total-body PET/CT may be physiological, more common in younger age, patients without diabetes, or lower fasting blood glucose.

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Acknowledgements

This work was supported by the fund from the National Natural Science Foundation of China (81971645) and Guangdong Provincial People's Hospital (KY0120211130).

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Author notes

  1. Xiaoyue Tan, Dongjiang Li and Xiaodong Wu equally contributed to this work.

Authors and Affiliations

  1. PET Center, Department of Nuclear Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China

    Xiaoyue Tan, Dongjiang Li, Qingyi Hou, Li He & Lei Jiang

  2. Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Xiaodong Wu

  3. Department of Neurosurgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Yong Yang

  4. Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Lei Jiang

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  1. Xiaoyue Tan
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Correspondence to Lei Jiang.

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Tan, X., Li, D., Wu, X. et al. Physiologically intense FDG uptake of distal spinal cord on total-body PET/CT. Ann Nucl Med 36, 643–650 (2022). https://doi.org/10.1007/s12149-022-01747-3

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  • DOI: https://doi.org/10.1007/s12149-022-01747-3

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