PET predicts outcomes for patients with cervical spinal cord compression

Metabolic activity in spine indicates optimal time for surgery

2013-09-04

(Press-News.org) Reston, Va. (September 4, 2013) – 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.

Cervical spinal stenosis is a condition in which the spinal canal narrows in the neck. While many patients lack symptoms, once symptoms appear, it usually indicates the presence of myelopathy. This compression can lead to progressive neurologic deficits, such as numbness, weakness or tingling in a leg, foot, arm or hand.

In the study "Hypermetabolism in 18F-FDG PET Predicts Favorable Outcome Following Decompressive Surgery in Patients with Degenerative Cervical Myelopathy," researchers aimed to assess the regional changes of glucose metabolism of the cervical spinal cord using 18F-FDG PET. "To date, experiences with 18F-FDG PET in symptomatic patients with degenerative cervical spine stenosis and consecutive compressive myelopathy are very limited," said Norbert Galldiks, MD, one of the lead researchers of the study. "In the present study, we present the results of preoperative magnetic resoncance imaging and 18F-FDG PET imaging and postoperative follow-up imaging 12 months after decompressive surgery. Imaging findings were correlated with the clinical outcome."

Researchers 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.

"A hypermetabolism of the cervical spinal cord at the level of cervical spine stenosis as indicated by a locally increased 18F-FDG uptake seems to be a marker for a potentially reversible phase of a compression-induced cervical myelopathy," explained Galldiks. "The lesion of the spinal cord seems to be predominantly functional. Presence of this metabolic pattern reflects the time frame when decompressive surgery can lead to substantial clinical improvement. In order to stratify eligible patients for decompressive surgery, our findings may help to implement 18F-FDG PET investigations of the cervical spine in clinical routine."

### Authors of the article "Hypermetabolism in 18F-FDG PET Predicts Favorable Outcome Following Decompressive Surgery in Patients with Degenerative Cervical Myelopathy"include Frank W. Floeth and Jörg Herdmann, Department of Neurosurgery, University Düsseldorf, Düsseldorf, Germany, and Department of Spine and Pain, St. Vinzenz Hospital, Düsseldorf, Germany; Norbert Galldiks, Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany, and Department of Neurology, University of Cologne, Cologne, Germany; Sven Eicker and Hans-Jakob Steiger, Department of Neurosurgery, University Düsseldorf, Düsseldorf, Germany; Gabriele Stoffels and Karl-Josef Langen, Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany; Gerald Antoch, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany; and Sasha Rhee, Department of Spine and Pain, St. Vinzenz Hospital, Düsseldorf, Germany.

ELSE PRESS RELEASES FROM THIS DATE:

More than one-third of populations worldwide may have low levels of vitamin D, study shows

2013-09-04

A new systematic review published in the British Journal of Nutrition*, is one of the first to focus on patterns of vitamin D status worldwide and in key population subgroups, using continuous values for 25(OH)D to improve comparisons. Principal investigator, Dr. Kristina Hoffmann of the Mannheim Institute of Public Health (MIPH), Medical Faculty Mannheim, Heidelberg University stated, "The strength of our study is that we used strict inclusion criteria to filter and compare data, using consistent values for 25(OH)D. Although we found a high degree of variability between ...

Biologists uncover details of how we squelch defective neurons

2013-09-04

Biologists at the University of California, San Diego have identified a new component of the cellular mechanism by which humans and animals automatically check the quality of their nerve cells to assure they're working properly during development. In a paper published in this week's issue of the journal Neuron, the scientists report the discovery in the laboratory roundworm C. elegans of a "quality check" system for neurons that uses two proteins to squelch the signals from defective neurons and marks them for either repair or destruction. "To be able to see, talk and ...

Young adults on the autism spectrum face tough prospects for jobs and independent living

2013-09-04

PHILADELPHIA -- For young adults with autism spectrum disorders (ASDs), making the transition from school to the first rites of independent adult life, including a first job and a home away from home, can be particularly challenging. Two newly published studies show precisely how stark the situation is for finding success in employment and independent living among young adults on the autism spectrum, compared to their peers with other types of disabilities. The researchers emphasize the need to strengthen services to help adolescents and young adults and their families ...

Personality interactions between animals may dictate outcomes in the wild

2013-09-04

PITTSBURGH—Examining the varying personality types of multiple animal species at once—in addition to common single-species studies—could help biologists better predict ecological outcomes, according to a recent University of Pittsburgh study. By observing the interplay in a common predator-prey system (the jumping spider and the house cricket), a team of Pitt biologists found that it was the interactions between the personality types of two species that best predicted survival outcomes—and not the personality types of either species alone. Their findings were highlighted ...

Developing & delivering interventions for pregnancy to reduce mother & child deaths

2013-09-04

A global group of experts has established research priorities addressing care for women prior to pregnancy, in a consensus statement published in PLOS Medicine this week. Sohni Dean and Zulfiqar Bhutta from the Aga Khan University, Karachi, collaborated with colleagues to identify the most important research areas for preconception care that need to be addressed in order to reduce deaths and disability in women and children. Prevention of maternal and child mortality has featured prominently in the Millennium Development Goals and the subsequent follow-up targets, but ...

Efforts to ensure earlier diagnosis of HIV infection across Europe are still needed

2013-09-04

Late diagnosis of HIV infection and entry into care remains a substantial problem across Europe according to a study published in this week's PLOS Medicine. The study, which was an international collaboration led by Amanda Mocroft from University College London, UK, analysed data from the COHERE in EuroCOORD study, an international collaboration including over 84,000 individuals with HIV infections from 35 European countries from January 2000 to January 2011. The researchers analysed data from over 20 observational studies from across Europe that contribute data to the ...

Roll-out of community voluntary male circumcision is linked to reduced HIV infection levels

2013-09-04

Roll-out of voluntary male circumcision services into the community of Orange Farm, South Africa is linked to substantial reductions in HIV infection levels, according to a study published in this week's PLOS Medicine. The study, (ANRS-12126), conducted by Bertran Auvert and colleagues from the University of Versailles (France), also reported that substantial uptake of voluntary male circumcision in one community was not linked to changes in sexual behavior that might affect HIV infection rates. In this study, Bertran Auvert and colleagues estimated HIV infection levels ...

Electromagnets guide heart device implantation, reduce radiation exposure

2013-09-04

Heart failure patients and others who need implanted cardiac devices to help their heart beat regularly may benefit from a new technology to guide their implantation procedure. It uses electromagnets, which work like a GPS tracking system, instead of radiation-based imaging, researchers reported in the American Heart Association journal Circulation: Arrhythmia and Electrophysiology. Electromagnetic tracking technology was used successfully to implant Cardiac Resynchronization Therapy (CRT) devices in heart failure patients, and substantially cut patients' and doctors' ...

Uncontrolled hypertension is common, but untreated, worldwide

2013-09-04

Hamilton, ON (September 3, 2013) - A global study has found that many patients don't know they have hypertension and, even if they do, too few are receiving adequate drug therapy for their hypertension. This is true in high income countries, like Canada, as well as middle and low income countries, say an international team of researchers led by the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences. The report, which was published today by JAMA, the journal of the American Medical Association, is part of the PURE (Prospective ...

Iranian telegraph operator, first to propose earthquake early warning system

2013-09-04

SAN FRANCISCO -- In 1909, an Iranian telegraph operator living in the remote desert town of Kerman noticed an unusual movement of the magnetic needle of his telegraph instrument. While other telegraph operators during the late 1800s and early 1900s noticed the phenomenon, the Iranian telegraph operator proposed an earthquake early warning system, as detailed in an article published today by the journal Seismological Research Letters (SRL). Nineteenth century telegraph operators in New Zealand, Switzerland, Chile, the Caribbean and elsewhere noted the usefulness of electric ...

LAST 30 PRESS RELEASES:

New study finds air pollution increases inflammation primarily in patients with heart disease

AI finds undiagnosed liver disease in early stages

The American Society of Tropical Medicine and Hygiene and the Bill & Melinda Gates Foundation announce new research fellowship in malaria genomics in honor of professor Dominic Kwiatkowski