Clinical impact of 18F-FDG PET/CT on the management and diagnosis of infectious spondylitis

Objective The aim of this study was to evaluate the impact of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) on the management of patients with infectious spondylitis. Materials and methods Twenty-nine patients with infectious spondylitis (9 with tuberculous spondylitis and 20 with pyogenic spondylitis) who had undergone an (18)F-FDG PET/CTexamination were retrospectively evaluated; 42 lesions were detected. A useful impact on the clinical management of infection therapy (start or longer duration of antibiotic therapy, or surgical intervention, etc) was defined as a strong impact, whereas gaining new information not affecting the clinical management of infection therapy from (18)F-FDG PET/CT was defined as a weak impact. No impact was defined as not obtaining any new information influencing infection therapy. Results (18)F-FDG PET/CT had a strong impact on the clinical management of 52% (15 of 29) of the patients. (18)F-FDG PET/CT detected 10 cases of spondylitis and one artificial graft infection that the clinician had not recognized, and the therapeutic period was extended in these patients. In five patients with tuberculous spondylitis, the (18)F-FDG PET/CT images were used to decide the biopsy sites in three patients and to determine which lesions required surgery in two patients. Conclusion (18)F-FDG PET/CT is useful for detecting infectious spondylitis. Nucl Med Commun 31:691-698 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.