Clinical Significance of Incidental Focal 18F-FDG Uptake in the Spinal Cord of Patients with Cancer

• Published in: Nuclear medicine and molecular imaging Vol. 51; no. 3; pp. 247 - 251
• Main Authors: Lim, Chae Hong, Hyun, Seung Hyup, Moon, Seung Hwan, Cho, Young Seok, Choe, Yearn Seong, Lee, Kyung-Han, Kim, Byung-Tae, Choi, Joon Young
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2017; Springer Nature B.V; 대한핵의학회
• Subjects: Abnormalities; Cancer; Cardiology; Clinical significance; Computed tomography; Imaging; Incidence; Lesions; Medical imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original; Original Article; Orthopedics; Patients; Positron emission; Radiology; Spinal cord; Tomography; Vertebrae; 방사선과학; Spinal cord; Differential diagnosis; F-FDG; PET/CT; Cancer
• ISSN: 1869-3474; 1869-3482
• DOI: 10.1007/s13139-016-0468-z

Purpose We investigated the incidence, location, and clinical significance of focal 18 F-FDG uptake of the spinal cord in patients with cancer. Methods We reviewed the medical records of 22,937 consecutive adult patients with known or suspicious malignancy who underwent 18 F-FDG PET/CT. PET/CT scans with incidental focal spinal cord uptake were selected and retrospectively reviewed to determine the presence, location, number, and maximum standardized uptake value (SUV max ) of any focal hypermetabolic lesions of the spinal cord. In subjects with focal spinal uptake, clinical characteristics and clinical follow-up results, including follow-up PET/CT, were reviewed. Results Incidental focal spinal cord uptake was observed in 69 of 22,937 adult patients (incidence = 0.3%; M:F = 31:38; age, 55.8 ± 14.7 years). Seventy-eight focal hypermetabolic lesions on spinal cord in the PET/CT scans of the 69 study subjects were analyzed. The most common sites of focal spinal cord uptake were the T12 vertebra (47/78; 60.3%) and L1 vertebra (20/78; 25.6%). Multifocal cord uptake was found in 8 of 69 patients (11.6%). The average SUV max for cord uptake was 2.5 ± 0.5 (range, 1.4∼3.9). There was no clinical or imaging evidence of abnormalities in the spinal cord, both at the time of PET/CT and during clinical follow-up. Conclusions Although incidental focal 18 F-FDG uptake of the spinal cord is rare in patients with cancer, it may be physiological or benign, but it should not be considered as malignant involvement. Common sites for the uptake were in the T12 and L1 spine levels.