| AJNMMI Copyright © 2011-present, All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711, USA |
Am J Nucl Med Mol Imaging 2013;3(4):317-325
Original Article
The normal variant 18F FDG uptake in the lower thoracic spinal cord segments in
cancer patients without CNS malignancy
Geetika Bhatt, Xiao-Feng Li, Angita Jain, Vivek R Sharma, Jianmin Pan, Archana Rai, Shesh Nath Rai, A. Cahid Civelek
Department of Internal Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA; Department of Diagnostic
Radiology, Division of Nuclear Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA; Kasturba Medical
College, Manipal University, Mangalore, India; Department of Internal Medicine, Division of Medical Oncology, University of Louisville
School of Medicine, Louisville, Kentucky, USA; Department of Bio informatics and Biostatistics, University of Louisville School of
Medicine, Louisville, Kentucky, USA
Received February 4, 2013; Accepted May 2, 2013; Epub July 10, 2013; Published July 15, 2013
Abstract: Focal increased lower thoracic spinal cord 18F FDG uptake is not infrequently observed as a normal physiological finding
and may be confused for spinal cord metastases. This study was conducted to evaluate a possible correlation between the lower
thoracic (T11-T12) spinal uptake and lower limb movements/ambulatory status of the patients as a surrogate. The primary endpoint
was to identify the possible cause(s) of the normal variant focal increased thoracic spinal cord (T11-T12) 18F FDG activity and
correlate it with the lower limb movements/ambulatory status of the patients. This was a retrospective analysis of PET-CT scans of
200 patients with solid and hematological malignancies. The focal relatively increased 18F FDG activity in the lower thoracic spinal
cord correlated strongly with the 18F FDG intensity of the liver, bowel, C3-C5 cervical cord activity, weight of the patient and injected
dose of 18F FDG. With regard to the primary endpoint, no significant correlation was found between the ambulatory status of patients
in any of the groups and thoracic spine SUVmax. This could be further assessed by performing dual studies in the same patient with
and without moderate to excessive leg motion. Identifying this variant focal increased 18F FDG activity can minimize errors of
misdiagnosis and unnecessary further investigation. (ajnmmi1302001).
Keywords: 18F FDG PET-CT, spinal cord, metastases, ambulatory status
Address correspondence to: A Cahid Civelek, Department of Diagnostic Radiology, Division of Nuclear Medicine, University of
Louisville School of Medicine, Louisville, Kentucky, 530 S. Jackson Street, CCB-C07, Louisville, Kentucky, 40202. Phone:
502-217-8285; Fax: 502-852-1754; E-mail: accivelek@gmail.com
Original Article
The normal variant 18F FDG uptake in the lower thoracic spinal cord segments in
cancer patients without CNS malignancy
Geetika Bhatt, Xiao-Feng Li, Angita Jain, Vivek R Sharma, Jianmin Pan, Archana Rai, Shesh Nath Rai, A. Cahid Civelek
Department of Internal Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA; Department of Diagnostic
Radiology, Division of Nuclear Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA; Kasturba Medical
College, Manipal University, Mangalore, India; Department of Internal Medicine, Division of Medical Oncology, University of Louisville
School of Medicine, Louisville, Kentucky, USA; Department of Bio informatics and Biostatistics, University of Louisville School of
Medicine, Louisville, Kentucky, USA
Received February 4, 2013; Accepted May 2, 2013; Epub July 10, 2013; Published July 15, 2013
Abstract: Focal increased lower thoracic spinal cord 18F FDG uptake is not infrequently observed as a normal physiological finding
and may be confused for spinal cord metastases. This study was conducted to evaluate a possible correlation between the lower
thoracic (T11-T12) spinal uptake and lower limb movements/ambulatory status of the patients as a surrogate. The primary endpoint
was to identify the possible cause(s) of the normal variant focal increased thoracic spinal cord (T11-T12) 18F FDG activity and
correlate it with the lower limb movements/ambulatory status of the patients. This was a retrospective analysis of PET-CT scans of
200 patients with solid and hematological malignancies. The focal relatively increased 18F FDG activity in the lower thoracic spinal
cord correlated strongly with the 18F FDG intensity of the liver, bowel, C3-C5 cervical cord activity, weight of the patient and injected
dose of 18F FDG. With regard to the primary endpoint, no significant correlation was found between the ambulatory status of patients
in any of the groups and thoracic spine SUVmax. This could be further assessed by performing dual studies in the same patient with
and without moderate to excessive leg motion. Identifying this variant focal increased 18F FDG activity can minimize errors of
misdiagnosis and unnecessary further investigation. (ajnmmi1302001).
Keywords: 18F FDG PET-CT, spinal cord, metastases, ambulatory status
Address correspondence to: A Cahid Civelek, Department of Diagnostic Radiology, Division of Nuclear Medicine, University of
Louisville School of Medicine, Louisville, Kentucky, 530 S. Jackson Street, CCB-C07, Louisville, Kentucky, 40202. Phone:
502-217-8285; Fax: 502-852-1754; E-mail: accivelek@gmail.com
 |  |  |  |  |  |  |