open access
The role of PET/CT in evaluation of Facet and Disc abnormalities in patients with low back pain using 18F-Fluoride
open access
Abstract
MATERIAL AND METHODS: 67 patients who presented with back pain underwent routine X-ray, CT and/or MRI, which failed to identify a clear cause, were referred to 18F-PET/CT. Among the main group, a subset of 25 patients had previous spine surgery consisting of laminectomy or discectomy (17 patients) and lumbar fusion (8 patients). The PET/CT scan was acquired on a GE VCT 64-Slice combined scanner. Imaging started 45-60 minutes after administration of 12-15 mCi (444-555 MBq) of 18F-Fluoride. The PET scan was acquired from the skull base through the inguinal region in 3D mode at 2 minutes/bed. A lowresolution, non-contrast CT scan was also acquired for anatomic localization and attenuation correction.
RESULTS: The 18F-PET/CT showed abnormal uptake in the spine in 56 patients, with an overall detection ability of 84%. Facet joints as a cause of back pain was much more frequent (25 with abnormal scans). One-third (36%) of the patients showed multiple positive uptake in both facet joints and disc areas (20/56). The patients were further divided into two groups. Group A consisted of 42 patients (63%) with back pain and no previous operative procedures, and the 18F-PET/CT showed a high sensitivity (88%) in identifying the source of pain in 37/42 patients. Group B included 25 patients (37%) with prior lumbar fusion or laminectomy, in which the PET/CT showed positive uptake in 76% (19/25 patients). 18F-PET/CT showed positive uptake in all patients (100%) with a history of pain after lumbar fusion, while in the laminectomy subgroup only 11 cases (65%) showed positive focal uptake.
CONCLUSIONS:18F-PET/CT has a potential use in evaluating adult patients with back pain. It has a promising role in identifying causes of persistent back pain following vertebral surgical interventions.
Abstract
MATERIAL AND METHODS: 67 patients who presented with back pain underwent routine X-ray, CT and/or MRI, which failed to identify a clear cause, were referred to 18F-PET/CT. Among the main group, a subset of 25 patients had previous spine surgery consisting of laminectomy or discectomy (17 patients) and lumbar fusion (8 patients). The PET/CT scan was acquired on a GE VCT 64-Slice combined scanner. Imaging started 45-60 minutes after administration of 12-15 mCi (444-555 MBq) of 18F-Fluoride. The PET scan was acquired from the skull base through the inguinal region in 3D mode at 2 minutes/bed. A lowresolution, non-contrast CT scan was also acquired for anatomic localization and attenuation correction.
RESULTS: The 18F-PET/CT showed abnormal uptake in the spine in 56 patients, with an overall detection ability of 84%. Facet joints as a cause of back pain was much more frequent (25 with abnormal scans). One-third (36%) of the patients showed multiple positive uptake in both facet joints and disc areas (20/56). The patients were further divided into two groups. Group A consisted of 42 patients (63%) with back pain and no previous operative procedures, and the 18F-PET/CT showed a high sensitivity (88%) in identifying the source of pain in 37/42 patients. Group B included 25 patients (37%) with prior lumbar fusion or laminectomy, in which the PET/CT showed positive uptake in 76% (19/25 patients). 18F-PET/CT showed positive uptake in all patients (100%) with a history of pain after lumbar fusion, while in the laminectomy subgroup only 11 cases (65%) showed positive focal uptake.
CONCLUSIONS:18F-PET/CT has a potential use in evaluating adult patients with back pain. It has a promising role in identifying causes of persistent back pain following vertebral surgical interventions.
Keywords
PET/CT; low back pain; facet arthropathy; bone scanning
Title
The role of PET/CT in evaluation of Facet and Disc abnormalities in patients with low back pain using 18F-Fluoride
Journal
Issue
Pages
17-21
Published online
2008-01-15
Page views
723
Article views/downloads
2364
Bibliographic record
Nucl. Med. Rev 2008;11(1):17-21.
Keywords
PET/CT
low back pain
facet arthropathy
bone scanning
Authors
Sherief Gamie
Tarek El-Maghraby