A comparison of the diagnostic value of MRI and (18)F-FDG-PET/CT in suspected spondylodiscitis.

C. Smids, I. Kouijzer, F. Vos, T. Sprong, A. Hosman, J. de Rooy, E. Aarntzen, L. de Geus-Oei, W. Oyen and C. Bleeker-Rovers




The purpose of this study was to evaluate the diagnostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT scan) and magnetic resonance imaging (MRI) in diagnosing spondylodiscitis and its complications, such as epidural and paraspinal abscesses.From January 2006 to August 2013 patients with a clinical suspicion of spondylodiscitis, with an infection, or with fever of unknown origin were retrospectively included if (18)F-FDG-PET/CT and MRI of the spine were performed within a 2-week time span. Imaging results were compared to the final clinical diagnosis and follow-up data were collected.Sixty-eight patients were included of whom 49 patients were diagnosed with spondylodiscitis. MRI showed an overall sensitivity of 67�\% and specificity of 84�\%. Diagnostic accuracy was 58�\%, when MRI was performed within 2�weeks after the start of symptoms and improved to 82�\%, when performed more than 2�weeks after onset of symptoms. (18)F-FDG-PET/CT showed a sensitivity of 96�\% and a specificity of 95�\%, with no relation to the interval between the scan and the start of symptoms.As compared to MRI, (18)F-FDG-PET/CT has superior diagnostic value for detecting early spondylodiscitis. After 2�weeks both techniques perform similarly.

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