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.
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.
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Authors: Stephanus T Malherbe; Shubhada Shenai; Katharina Ronacher; Andre G Loxton; Gregory Dolganov; Magdalena Kriel; Tran Van; Ray Y Chen; James Warwick; Laura E Via; Taeksun Song; Myungsun Lee; Gary Schoolnik; Gerard Tromp; David Alland; Clifton E Barry; Jill Winter; Gerhard Walzl; Lance Lucas; Gian van der Spuy; Kim Stanley; Lani Thiart; Bronwyn Smith; Nelita Du Plessis; Caroline G G Beltran; Elizna Maasdorp; Annare Ellmann; Hongjo Choi; Joonsung Joh; Lori E Dodd; Brian Allwood; Coenie Koegelenberg; Morné Vorster; Stephanie Griffith-Richards Journal: Nat Med Date: 2016-09-05 Impact factor: 53.440
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