Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using <sup>18</sup>F-FDG-PET/MRI
Purpose: There is still no definite method to determine therapeutic response in pyogenic vertebral osteomyelitis (PVO). We analyzed the value of <sup>18</sup>F-fluorodeoxyglucose positron emission tomography (FDG-PET) for assessing therapeutic response in PVO. Methods: This retrospective...
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MDPI AG
2020-11-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/10/11/916 |
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| author | Ikchan Jeon Eunjung Kong Sang Woo Kim Ihn Ho Cho Cheol Pyo Hong |
| author_facet | Ikchan Jeon Eunjung Kong Sang Woo Kim Ihn Ho Cho Cheol Pyo Hong |
| author_sort | Ikchan Jeon |
| collection | DOAJ |
| description | Purpose: There is still no definite method to determine therapeutic response in pyogenic vertebral osteomyelitis (PVO). We analyzed the value of <sup>18</sup>F-fluorodeoxyglucose positron emission tomography (FDG-PET) for assessing therapeutic response in PVO. Methods: This retrospective study included 53 patients (32 men and 21 women) with lumbar PVO. The results of clinical assessments for therapeutic response were divided into “Cured” (group C) and “Non-cured” (group NC). The differences in clinical and radiological features of PVO lesions between the two groups were analyzed using clinical data and simultaneous FDG-PET/magnetic resonance imaging (MRI) obtained at each clinical assessment. Results: Clinical assessments and FDG-PET/MRIs were performed at 41.89 ± 16.08 (21–91) days of parenteral antibiotic therapy. There were 39 patients in group C and 14 in group NC. Diagnostic accuracies (DAs) of FDG uptake intensity-based interpretation and C-reactive protein (CRP) for residual PVO were as follows (<i>p</i> < 0.01): 84.9% of the maximum standardized uptake value of PVO lesion (PvoSUV<sub>max</sub>), 86.8% of ΔPvoSUV<sub>max</sub>−NmlSUV<sub>max</sub> (SUV<sub>max</sub> of normal vertebra), 86.8% of ΔPvoSUV<sub>max</sub>−NmlSUV<sub>mean</sub> (SUV<sub>mean</sub> of normal vertebra), and 71.7% of CRP. DAs were better (92.5–94.3%) when applying FDG uptake intensity-based interpretation and CRP together. Under the FDG uptake distribution-based interpretation, FDG uptake was significantly limited to intervertebral structures in group C (<i>p</i> = 0.026). Conclusion: The interpretations of intensity and distribution of FDG uptake on FDG-PET are useful for detecting residual PVO in the assessment of therapeutic response of PVO. The combination of FDG-PET and CRP is expected to increase DA for detecting residual PVO. |
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| id | doaj.art-a80e9767477b4cb881aa1b409b56a101 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T15:01:18Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a80e9767477b4cb881aa1b409b56a1012023-11-20T20:12:34ZengMDPI AGDiagnostics2075-44182020-11-01101191610.3390/diagnostics10110916Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using <sup>18</sup>F-FDG-PET/MRIIkchan Jeon0Eunjung Kong1Sang Woo Kim2Ihn Ho Cho3Cheol Pyo Hong4Department of Neurosurgery, Yeungnam University College of Medicine, Daegu 42415, KoreaDepartment of Nuclear Medicine, Yeungnam University College of Medicine, Daegu 42415, KoreaDepartment of Neurosurgery, Yeungnam University College of Medicine, Daegu 42415, KoreaDepartment of Nuclear Medicine, Yeungnam University College of Medicine, Daegu 42415, KoreaDepartment of Radiological Science, Catholic University of Daegu, Gyeongbuk 38430, KoreaPurpose: There is still no definite method to determine therapeutic response in pyogenic vertebral osteomyelitis (PVO). We analyzed the value of <sup>18</sup>F-fluorodeoxyglucose positron emission tomography (FDG-PET) for assessing therapeutic response in PVO. Methods: This retrospective study included 53 patients (32 men and 21 women) with lumbar PVO. The results of clinical assessments for therapeutic response were divided into “Cured” (group C) and “Non-cured” (group NC). The differences in clinical and radiological features of PVO lesions between the two groups were analyzed using clinical data and simultaneous FDG-PET/magnetic resonance imaging (MRI) obtained at each clinical assessment. Results: Clinical assessments and FDG-PET/MRIs were performed at 41.89 ± 16.08 (21–91) days of parenteral antibiotic therapy. There were 39 patients in group C and 14 in group NC. Diagnostic accuracies (DAs) of FDG uptake intensity-based interpretation and C-reactive protein (CRP) for residual PVO were as follows (<i>p</i> < 0.01): 84.9% of the maximum standardized uptake value of PVO lesion (PvoSUV<sub>max</sub>), 86.8% of ΔPvoSUV<sub>max</sub>−NmlSUV<sub>max</sub> (SUV<sub>max</sub> of normal vertebra), 86.8% of ΔPvoSUV<sub>max</sub>−NmlSUV<sub>mean</sub> (SUV<sub>mean</sub> of normal vertebra), and 71.7% of CRP. DAs were better (92.5–94.3%) when applying FDG uptake intensity-based interpretation and CRP together. Under the FDG uptake distribution-based interpretation, FDG uptake was significantly limited to intervertebral structures in group C (<i>p</i> = 0.026). Conclusion: The interpretations of intensity and distribution of FDG uptake on FDG-PET are useful for detecting residual PVO in the assessment of therapeutic response of PVO. The combination of FDG-PET and CRP is expected to increase DA for detecting residual PVO.https://www.mdpi.com/2075-4418/10/11/916pyogenicspinetherapeutic responseFDG-PET/MRISUV |
| spellingShingle | Ikchan Jeon Eunjung Kong Sang Woo Kim Ihn Ho Cho Cheol Pyo Hong Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using <sup>18</sup>F-FDG-PET/MRI Diagnostics pyogenic spine therapeutic response FDG-PET/MRI SUV |
| title | Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using <sup>18</sup>F-FDG-PET/MRI |
| title_full | Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using <sup>18</sup>F-FDG-PET/MRI |
| title_fullStr | Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using <sup>18</sup>F-FDG-PET/MRI |
| title_full_unstemmed | Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using <sup>18</sup>F-FDG-PET/MRI |
| title_short | Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using <sup>18</sup>F-FDG-PET/MRI |
| title_sort | assessment of therapeutic response in pyogenic vertebral osteomyelitis using sup 18 sup f fdg pet mri |
| topic | pyogenic spine therapeutic response FDG-PET/MRI SUV |
| url | https://www.mdpi.com/2075-4418/10/11/916 |
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