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Evaluation of neck pain with 18F-NaF PET/CT

Tiernan ByrnesaThe National Hospital for Neurology and Neurosurgery bInstitute of Nuclear Medicine cDepartment of Radiology, University College London Hospitals NHS Trust, London, UKWanying XieInstitute of Nuclear MedicineOmar AlmukhailedInstitute of Nuclear MedicineAnthony D’SaInstitute of Nuclear MedicineFuad NovruzovInstitute of Nuclear MedicineAdrian T. H. CaseyThe National Hospital for Neurology and NeurosurgeryCharles HouseDepartment of Radiology, University College London Hospitals NHS Trust, London, UKJamshed BomanjiInstitute of Nuclear Medicine
ABI

Abstract

AIM: (18)F-Sodium fluoride ((18)F-NaF) PET/computed tomography (CT) has improved spatial resolution in the cervical spine compared with single photon emission computed tomography/CT techniques using traditional tracers. Limited data are available, however, on its effectiveness in the management of the symptomatic cervical spine, and the aim of this study was therefore to elucidate this issue. PATIENTS AND METHODS: A retrospective study was carried out between April 2011 and April 2012. Across this period, 66 patients were referred to the department for the assessment of neck pain, of whom 58 were included in the study. (18)F-NaF was used as the tracer and images were acquired on an integrated PET/CT scanner. All studies were evaluated by either consultant nuclear medicine physicians or by a radiologist. Two consultant neurosurgeons correlated the imaging reports with the clinical data from the patient notes to give an overall impression as to how beneficial the test had been with regard to patient management. RESULTS: In 49/58 (84.5%) cases, the (18)F-NaF PET/CT report was thought to have been clinically useful in patient management. In 9/58 (15.5%) cases, the report was thought not to have been clinically beneficial, generally because of high background vertebral uptake of (18)F-fluoride secondary to degenerative disease. CONCLUSION: As our experience with (18)F-NaF PET/CT broadens, we believe that it will become an increasingly important tool in the evaluation and management of the symptomatic cervical spine.

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