18F]FDG-PET Evaluation of Spinal Pathology in Patients in Oncology: Pearls and Pitfalls for the Neuroradiologist.

P.Y Patel,B Griffith,I Dalal

doi:10.3174/ajnr.a7308

P.Y Patel, B Griffith + Show 1 more

Open Access

https://doi.org/10.3174/ajnr.a7308

Copy DOI

Abstract

[18F]FDG-PET is a widely used technique for specific evaluation of disease and treatment response in oncology. However, the principles behind [18F]FDG-PET imaging allow a wide-ranging array of benign and malignant pathologies to be identified on both initial and routine surveillance imaging. This is important for clinicians and radiologists, alike, in that effective and accurate evaluation of malignancy and metastatic disease, specifically involving the spine and central nervous system, is crucial. In this article, we review the normal and posttherapy appearance of the spine on [18F]FDG-PET, the various types and patterns of metastatic disease that involve the spine and spinal cord, and, finally, important spinal pathologies that may mimic malignancy on [18F]FDG-PET.

Highlights

SUMMARY: [18F]FDG-PET is a widely used technique for specific evaluation of disease and treatment response in oncology
Metastatic disease can occur anywhere, the spine is of particular importance, because it is the third most frequent site of distant metastatic disease and because many nonmalignant processes, some of which can appear nearly identical to metastatic foci on [18F] FDG-PET, are frequently identified involving the spine during the course of a patient’s routine oncologic work-up.[2]
While MR imaging is the most crucial imaging technique used to assess spinal metastatic disease, various metastatic disease patterns have been demonstrated on [18F]FDG-PET, which can help in disease localization and assessment.[2,3]