Physiological distribution of 18F-FDG in the spinal cord: A systematic review

Context: The importance of physiologic distribution of 18 F-FDG in the spinal cord. Objective: The recognition of the physiologic distribution of 18 F-FDG in the spinal cord is pivotal for accurate PET/CT imaging interpretation, especially in oncologic patients. Therefore, we performed a systematic...

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Bibliographic Details
Published in:The journal of spinal cord medicine 2021-07, Vol.44 (4), p.517-524
Main Authors: Kiamanesh, Zahra, Banezhad, Farnaz, Nasiri, Zakieh, Emami, Farshad, Treglia, Giorgio, Sadeghi, Ramin
Format: Article
Language:English
Subjects:
F-FDG
PET
Physiological uptake
Positron emission tomography
Review
Reviews
Spinal cord
Spine
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Summary:Context: The importance of physiologic distribution of 18 F-FDG in the spinal cord. Objective: The recognition of the physiologic distribution of 18 F-FDG in the spinal cord is pivotal for accurate PET/CT imaging interpretation, especially in oncologic patients. Therefore, we performed a systematic review to investigate the normal distribution of 18 F-FDG throughout the spinal cord. Methods: Data sources: We carried out a comprehensive search of the literature on the physiologic patterns of 18 F-FDG distribution in the spinal cord. PubMed and Scopus databases were searched using the following keywords: "spinal cord" AND "FDG". Data extraction: Findings of the selected articles were described. Results: Thirteen studies comprising 24,125 patients entered the systematic review. These investigations showed discrepancies in location, size, number, and intensity of 18 F-FDG uptake throughout the spinal cord. However, cumulative results showed that 18 F-FDG uptake was higher in the lower thoracic portion of spinal cord (T11-T12). Moreover, a decreasing trend in 18 F-FDG uptake was observed from cervical to lumbar levels. Low maximal standardized uptake values, female sex, and higher body weight seem to be related to the physiological spinal cord 18 F-FDG uptake. Conclusions: On 18 F-FDG PET/CT imaging, focal hypermetabolism of the spinal cord at the level of lower thoracic and lower cervical vertebrae should be considered physiological until proven otherwise.
ISSN:1079-0268
2045-7723
DOI:10.1080/10790268.2019.1672954