18F-FDG PET May Predict Cervical Spinal Cord Compression Outcome

Clinicians using 18F-FDG PET on patients with cervical spinal cord compression may be able to predict an improved outcome after surgical decompression.

Imaging with 18F-FDG PET may predict outcomes for patients with degenerative cervical myelopathy, according to a study published in The Journal of Nuclear Medicine.

Researchers in Germany prospectively assessed regional changes in glucose metabolism in the cervical spinal cord using 18F-FDG PET in 20 patients with symptomatic degenerative monosegmental cervical stenosis who underwent decompressive surgery.

“To date, experiences with 18F-FDG PET in symptomatic patients with degenerative cervical spine stenosis and consecutive compressive myelopathy are very limited,” said one of the lead researchers, Norbert Galldicks, MD, in a release. "In the present study, we present the results of preoperative magnetic resonance imaging and 18F-FDG PET imaging and postoperative follow-up imaging 12 months after decompressive surgery. Imaging findings were correlated with the clinical outcome."

The researchers assessed patient functional status score, 18F-FDG uptake, and MR imaging changes pre- and postoperatively. The results showed that preoperatively, 10 patients had increased 18F-FDG uptake at the site of the spinal cord compression and were classified as myelopathy type 1.

The remaining patients had inconspicuous 18F-FDG uptake and were classified as myelopathy type 2. Postoperatively, those with myelopathy type 1 had a marked decrease in 18F-FDG uptake, but type 2 patients only demonstrated a moderate decline.

The researchers concluded that the focal glucose hypermetabolism at the level of cervical spinal cord compression may predict an improved outcome after surgical decompression.

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