Abstract
Purpose
This is a prospective non-randomized observation study done on 33 patients with uncomplicated spinal tuberculosis to observe the imaging characteristics on sequential F-18 FDG PET CT scans.
Methods
33 consecutive patients with pathologically proven spinal tuberculosis underwent a baseline contrast-enhanced whole body FDG PET scan before initiation of antitubercular therapy, 6 and 12 months and at 18 months or the end of antitubercular therapy.
Result
The baseline peak SUVmax of lesions in our 33 cases had values ranging from 5.9 to 30.3 (mean 14.8). 63.6 % patients had clinically occult non-contiguous multifocal skeletal involvement at the time of the baseline whole body PET CT scanning. The mean change in SUVmax at various time points was highly significant (p value < 0.001).
Conclusion
SUVmax can be taken as a reliable marker for serial quantification of metabolic activity in spinal tuberculosis. This may translate into a potential role for FDG as an imaging biomarker for noninvasive response evaluation in skeletal tuberculosis.
Similar content being viewed by others
References
Cormican L, Hammal R, Messenger J, Milburn HJ (2006) Current difficulties in the diagnosis and management of spinal tuberculosis. Postgrad Med J 82(963):46–51
Ramachandran S, Clifton IJ, Collyns TA, Watson JP, Pearson SB (2006) The treatment of spinal tuberculosis: a retrospective study. Int J Tuberc Lung Dis 23:186–189
American Thoracic Society Centers for Disease Control and Prevention, Infectious Diseases Society of America (2003) Treatment of tuberculosis. Am J Respir Crit Care Med 167:603–662
Harkirat S, Anand SS, Indrajit IK, Dash AK, Pictorial essay (2008) PET/CT in tuberculosis. Indian J Radiol Imaging 18:141–147
Davis SL, Nuermberger EL, Um PK, Vidal C, Jedynak B, Pomper MG (2009) Noninvasive pulmonary [18F]-2-fluoro-deoxy-d-glucose positron emission tomography correlates with bactericidal activity of tuberculosis drug treatment. Antimicrob Agents Chemother 53(11):4879–4884
Dass B, Puet TA, Watanakunakor C (2002) Tuberculosis of the spine (Pott’s disease) presenting as ‘compression fractures’. Spinal Cord 40:604–608. doi:10.1038/sj.sc.3101365
Turgut M (2001) Spinal tuberculosis (Pott’s disease): its clinical presentation, surgical management, and outcome. a survey study on 694 patients. Neurosurg Rev 24:8–13. doi:10.1007/PL00011973
Nussbaum ES, Rockwold GL, Bergman TA, Erickson DL, Seljeskog EL (1995) Spinal tuberculosis: a diagnostic and management challenge. J Neurosurg 83:243–247
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dureja, S., Sen, I.B. & Acharya, S. Potential role of F18 FDG PET-CT as an imaging biomarker for the noninvasive evaluation in uncomplicated skeletal tuberculosis: a prospective clinical observational study. Eur Spine J 23, 2449–2454 (2014). https://doi.org/10.1007/s00586-014-3483-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-014-3483-8