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Open AccessArticle

Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using 18F-FDG-PET/MRI

1
Department of Neurosurgery, Yeungnam University College of Medicine, Daegu 42415, Korea
2
Department of Nuclear Medicine, Yeungnam University College of Medicine, Daegu 42415, Korea
3
Department of Radiological Science, Catholic University of Daegu, Gyeongbuk 38430, Korea
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(11), 916; https://doi.org/10.3390/diagnostics10110916
Received: 29 September 2020 / Revised: 5 November 2020 / Accepted: 6 November 2020 / Published: 8 November 2020
(This article belongs to the Special Issue Positron Emission Tomography (PET) Imaging for Therapy Monitoring)
Purpose: There is still no definite method to determine therapeutic response in pyogenic vertebral osteomyelitis (PVO). We analyzed the value of 18F-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 (p < 0.01): 84.9% of the maximum standardized uptake value of PVO lesion (PvoSUVmax), 86.8% of ΔPvoSUVmax−NmlSUVmax (SUVmax of normal vertebra), 86.8% of ΔPvoSUVmax−NmlSUVmean (SUVmean 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 (p = 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. View Full-Text
Keywords: pyogenic; spine; therapeutic response; FDG-PET/MRI; SUV pyogenic; spine; therapeutic response; FDG-PET/MRI; SUV
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MDPI and ACS Style

Jeon, I.; Kong, E.; Kim, S.W.; Cho, I.H.; Hong, C.P. Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using 18F-FDG-PET/MRI. Diagnostics 2020, 10, 916. https://doi.org/10.3390/diagnostics10110916

AMA Style

Jeon I, Kong E, Kim SW, Cho IH, Hong CP. Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using 18F-FDG-PET/MRI. Diagnostics. 2020; 10(11):916. https://doi.org/10.3390/diagnostics10110916

Chicago/Turabian Style

Jeon, Ikchan; Kong, Eunjung; Kim, Sang W.; Cho, Ihn H.; Hong, Cheol P. 2020. "Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using 18F-FDG-PET/MRI" Diagnostics 10, no. 11: 916. https://doi.org/10.3390/diagnostics10110916

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