A comparison of the diagnostic value of MRI and 18F-FDG-PET/CT in suspected spondylodiscitis.
PURPOSE
The purpose of this study was to evaluate the diagnostic value of 18F-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 18F-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. 18F-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, 18F-FDG-PET/CT has superior diagnostic value for detecting early spondylodiscitis. After 2 weeks both techniques perform similarly.
['Smids|Carolijn|C|', 'Kouijzer|Ilse J E|IJ|', 'Vos|Fidel J|FJ|', 'Sprong|Tom|T|', 'Hosman|Allard J F|AJ|', 'de Rooy|Jacky W J|JW|', 'Aarntzen|Erik H J G|EH|', 'de Geus-Oei|Lioe-Fee|LF|', 'Oyen|Wim J G|WJ|', 'Bleeker-Rovers|Chantal P|CP|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D002648:Child D015299:Discitis D020802:Epidural Abscess D005260:Female D019788:Fluorodeoxyglucose F18 D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D000072078:Positron Emission Tomography Computed Tomography D012189:Retrospective Studies D012680:Sensitivity and Specificity D013131:Spine D055815:Young Adult
MRI 18F-FDG-PET/CT Spondylodiscitis Abscess