Ahmed Wafaie, Presenter: Nothing to Disclose

Nevien Ezzat El-Liethy, Abstract Co-Author: Nothing to Disclose

Hassan Kassem MD, Abstract Co-Author: Nothing to Disclose

Magdy Kotb, Abstract Co-Author: Nothing to Disclose

To compare the diagnostic value of combined F18-FDG PET/CT, CT and MRI in detection of spinal metastatic lesions and itsimpact on clinical management

22 patients with biopsy-proven malignancy were enrolled. All underwent spinal MRI and whole body F-18-FDG PET/CT examinations using standard techniques. The diagnostic capabilities of the imaging modalities were compared in the same spinal field of view. FDG PET/CT and MRI findings were compared with the results of biopsy or clinical/ radiological follow up for at least 12 months as reference standards

A total of 214 vertebral lesions were detected in 22 cancer patients based on combined clinical/ radiological follow up, these lesions were divided into: 129 metastatic & 85 benign lesions. Moreover these 22 patients were divided into: 12 with spinal metastases and 10 free from metastases. Both lesion&patient-based data analysis showed significant higher diagnostic accuracy for combined F18-FDG PET/CT (98.5% and 95.4%) compared to MRI (86% and 68%) and CT (79.5% & 54.5%) respectively. The significant difference between F18 FDG PET/CT and morphological techniques were more obvious on specificity indices rather than sensitivity indices in both lesion and patient based analysis. On lesion-based analysis, the sensitivity, specificity,NPV and PPV for F18 FDG PET/CT were 99%, 98%, 98% & 99%, For MRI were 88.4%, 82.3%,88.4%and 82.3%, and for CT were 83.7%, 73%,82.4 and 74.5% respectively. On patient-based analysis the sensitivity and specificity for F18 FDG PET/CT were 100% & 90% compared to 75% &60% in MRI and 66.6 % &40% in CT. The relative superiority of the F18 FDG based technique compared to the morphological techniques in respect to sensitivity and specificity provided significant changes in patient management in 27.2 % & 41%compared to MRI & CT respectively.

Combined F18 FDG PET/CT scan showed the highest sensitivity, specificity and accuracy followed by MRI and lastly CT in detection of spinal metastases . Consequently18F-FDG PET/CT has a better impact on clinical management compared to MRI & CT

F18 FDG PET/CT showed much higher sensitivity, specificity and accuracy compared to MRI and CT in detection of spinal metastatic lesions and hence had a high impact on clinical management. therefore, a whole body FDG PET/CT is enough for staging/ re-staging and MRI is not required unless clinically suspected neural compromise is there

Wafaie, A, El-Liethy, N, Kassem, H, Kotb, M, A Comparison between FDG PET/CT, CT and MRI in Detection of Spinal Metastases and Its Impact on Clinical Management  [ MI Scavenger Hunt! ].  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009065.html