For patients with degenerative cervical myelopathy, imaging with 18F-FDG positron emission tomography (PET) could act as a marker for a potentially reversible phase of the disease in which substantial clinical improvement can be achieved. According to research published in the September issue of The Journal of Nuclear Medicine, patients who exhibited hypermetabolism at the point of compression in their spine experienced improved outcomes after undergoing decompressive surgery.
In the study “Hypermetabolism in 18F-FDG PET Predicts Favorable Outcome Following Decompressive Surgery in Patients with Degenerative Cervical Myelopathy,” researchers assessed the regional changes of glucose metabolism of the cervical spinal cord using 18F-FDG PET. They observed two significantly different patterns of 18F-FDG uptake among the 20 study participants prior to surgery: ?approximately half of the patients had increased 18F-FDG uptake at the site of spinal cord compression and were classified as myelopathy type 1, while the other half had inconspicuous 18F-FDG uptake and were classified as myelopathy type 2.
Post-operatively, those with myelopathy type 1 had a marked decrease in 18F-FDG uptake, while myelopathy type 2 patients had only a moderate decline in uptake.
The overall outcome in myelopathy type 1 patients was favorable, and the patients showed significant improvement on their functional status assessment. In contrast, there was no significant clinical change in patients with inconspicuous 18F-FDG uptake.
