Metabolic neuroimaging of the cervical spinal cord in patients with compressive myelopathy: a high-resolution positron emission tomography study

Abstract

Object. The authors conducted a study to examine whether high-resolution [18F]fluorodeoxyglucose (FDG)—positron emission tomography (PET) could be used to visualize deterioration of cervical spinal cord function associated with various degrees of compression and to determine its potential usefulness during assessment of compressive myelopathy. Methods. In 23 patients requiring decompressive surgery for myelopathy FDG-PET was performed. The preoperative findings of high-resolution FDG-PET were compared with the neurological scores and magnetic resonance (MR) imaging findings. The preoperative standardized uptake value (SUV) of FDG utilization rate of the cervical cord correlated with the pre- (r = 0.497, p = 0.016) and postoperative neurological scores (r = 0.595, p = 0.003), as well as with the rate of neurological improvement postoperatively (r = 0.538, p = 0.008). The FDG utilization rate did not correlate with the high signal intensity on T2-weighted MR images. Conclusions. Analysis of these results indicates that high-resolution FDG-PET imaging provides useful qualitative and quantitative estimates of impaired metabolic activity of the compromised cervical cord that correlate closely with the severity of neurological dysfunction.