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

• Published in: Infection Vol. 45; no. 1; pp. 41 - 49
• Main Authors: Smids, Carolijn, Kouijzer, Ilse J. E., Vos, Fidel J., Sprong, Tom, Hosman, Allard J. F., de Rooy, Jacky W. J., Aarntzen, Erik H. J. G., de Geus-Oei, Lioe-Fee, Oyen, Wim J. G., Bleeker-Rovers, Chantal P.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2017
• Subjects: Family Medicine; General Practice; Infectious Diseases; Internal Medicine; Medicine; Medicine & Public Health; Original Paper; Spondylodiscitis; MRI; F-FDG-PET/CT; Abscess
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-016-0914-y

Purpose 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. Methods 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. Results 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. Conclusions As compared to MRI, 18 F-FDG-PET/CT has superior diagnostic value for detecting early spondylodiscitis. After 2 weeks both techniques perform similarly.