18F-FDG PET/CT features of spinal tuberculosis

Abstract

Objective To investigate the diagnostic value of 18F-FDG PET/CT features of spinal tuberculosis. Methods 18F-FDG PET/CT imaging manifestation of 125 cases(70 males, 55 females, average age 44.3 years) with osseous or mixed vertebra bone destruction from January 2006 to June 2014 were analyzed retrospectively. The patients included 32 cases with spinal tuberculosis (50 lesions, study group) and 93 cases with other diseases (150 lesions, control group). The corresponding FDG PET/CT features were analyzed by two classification logistic regression (Forward: LR), then FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis were obtained. The sensitivity and specificity of those FDG PET/CT features were calculated. Results Odds ratio (OR) of FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis from high to low were paraspinalcold abscess(20.790),cold zone(10.528), intervertebral disc involvement(5.394), continuous vertebral involvement(3.493). The diagnostic sensitivity and specificity were 22.0%(11/50), 99.3%(149/150) forcold abscess, 70.0%(35/50), 90.0%(135/150) forcold zone, 82.0%(41/50), 83.0%(125/150) for intervertebral disc involvement, 82.0%(41/50), 78.0%(117/150) for continuous vertebral involvement, respectively. Spinal tuberculosis often had two or more signs. Thecontinuous vertebral involvement + intervertebral disc involvementwas most common, with the diagnostic sensitivity and specificity of 78.0%(39/50) and 88.7%(133/150). The diagnostic sensitivity and specificity ofcontinuous vertebral involvement+ intervertebral disc involvement+ cold zonewere 58.0%(29/50), 96.0%(144/150), and those of four features concurrence were 14.0%(7/50), 100%(150/150), respectively. Conclusion Regression analysis shows that FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis are paraspinalcold abscess,cold zone, intervertebral disc involvement, continuous vertebral involvement, which have high diagnostic sensitivity and specificity. Key words: Spinal tuberculosis; Tomography, emission-computed; Tomography, X-ray computed; Deoxyglucose