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Skeletal Radiology
Erschienen in:

04.01.2020 | Scientific Article

Incremental value of FDG-PET/CT to monitor treatment response in infectious spondylodiscitis

verfasst von: Elda Righi, Alessia Carnelutti, Daniele Muser, Fernando Di Gregorio, Barbara Cadeo, Giulia Melchioretto, Maria Merelli, Abass Alavi, Matteo Bassetti

Erschienen in: Skeletal Radiology | Ausgabe 6/2020

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Abstract

Objective

To assess the added value of serial 2-deoxy-2-[18F]fluoro-D-glucose (FDG) uptake analysis in predicting clinical response to treatment in infectious spondylodiscitis (IS). We sought to analyze changes in quantitative FDG-PET/CT parameters among patients with clinical response or treatment failure and to compare the sensitivity and specificity of serial FDG-PET/CT and MRI in predicting treatment response in IS.

Materials and methods

This retrospective study consisted of 68 FDG-PET/CT examinations in 34 patients performed before and after at least 2 weeks of antibiotic treatment. Serial MRI scans were available in 32 (94%) patients before and after treatment. FDG-avid lesions were quantified as maximum standardized uptake value (SUVmax), partial-volume corrected lesion metabolic volume (LMV), and partial-volume corrected lesion metabolic activity (LMA).

Results

All FDG-PET/CT parameters significantly decreased in patients with clinical improvement (31/34, 91%, P < 0.001), while patients with disease progression did not show FDG-PET/CT improvement. FDG uptake decrease was similar between patients undergoing early assessment (< 6 weeks) compared with those performing FDG-PET/CT after 6 weeks of treatment. SUVmax, LMV, and LMA decrease over time was 39.0%, 97.4%, and 97.1%, respectively. In predicting clinical responses, SUVmax reduction > 15% and > 25% showed 94% and 89% sensitivity and 67% and 100% specificity compared with 37% and 50% of MRI, respectively. Low degree of agreement with clinical response was shown for MRI compared with FDG-PET/CT parameters using the Cohen kappa coefficient.

Conclusions

FDG-PET/CT monitoring is a valuable tool to predict clinical response to treatment in IS and has greater sensitivity and specificity compared with MRI.
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Metadaten
Titel
Incremental value of FDG-PET/CT to monitor treatment response in infectious spondylodiscitis
verfasst von
Elda Righi
Alessia Carnelutti
Daniele Muser
Fernando Di Gregorio
Barbara Cadeo
Giulia Melchioretto
Maria Merelli
Abass Alavi
Matteo Bassetti
Publikationsdatum
04.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 6/2020
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-03328-4

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