31 March 2024: Review Articles
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future Applications
Weijian Zhu 12BCEF , Sirui Zhou 3D , Jinming Zhang 1D , Li Li 4B , Pin Liu 2A , Wei Xiong 1A*DOI: 10.12659/MSM.943168
Med Sci Monit 2024; 30:e943168
Introduction
Segmental Structure of the Spine
Diagnostic Value of Plain Radiographs and Computed Tomography for NVO
Diagnostic Value of MRI in NVO
Pyogenic Spondylitis
Tuberculous Spondylitis
Brucellar Spondylitis
Fungal Spondylitis
Diagnostic Value of Positron Emission Tomography for NVO
Artificial Intelligence Applications and the Future
Conclusions
References
Table 3 The application of PET-CT and artificial intelligence in the diagnosis of native vertebral osteomyelitis.
| Authors | Year | Sample size | Disease conditions | Research purpose | Results |
|---|---|---|---|---|---|
| Smid et al []18 | 2017 | 68 | Median age 64 | To investigate the diagnostic value of 18F-FDG PET, CT and MRI for spondylitis and its complications | 18F-FDG-PET/CT shows increased 18F-FDG uptake in the spinal region compared to uptake in the bone marrow, or increased 18F-FDG uptake in the soft tissues surrounding the spine. PET-CT can show the early stages of spinal inflammation because it visualizes increased glucose metabolism, whereas MRI relies only on anatomical changes. PET-CT can detect other foci of infection on a systemic scale and may even recognize endocarditis (which occurs relatively often in conjunction with discitis) |
| Kim et al []66 | 2018 | 81 | – | Evaluating the performance of DCNN for differentiating tuberculous and septic spondylitis on MRI imaging | In PET-CT images, spondylolisthesis is manifested by increased uptake of 18F-FDG, shown as a hypermetabolic region. This increased uptake can be observed in the vertebral body, intervertebral discs, and surrounding soft tissues. The sensitivity, specificity, PPV, and NPV of 18F-FDG-PET/CT for the diagnosis of spondylolisthesis were 100%, 83.3%, 90.9%, and 100%, respectively |
| Ioannou et al []58 | 2013 | 10 | – | To determine the role of F-18 FDG PET/CT scanning in the diagnosis of BS and monitoring its treatment outcome | In this study, initial MRI in all patients showed increased F-18 FDG activity in the infected vertebral region. Compared with MRI, F-18 FDG PET/CT provided additional information in 4 patients. It revealed additional vertebral lesions (3 patients), lymphadenitis, arthritis, and organomegaly, as well as new paravertebral soft tissue involvement and epidural masses. This additional information had an impact on the duration of treatment in these patients |
| Gunes et al []59 | 2016 | 32 | – | Exploring the value of FDG-PET/CT in the diagnosis of spondylitis | FDG-PET/CT can show increased FDG uptake in the patient’s intervertebral discs and vertebral bodies, correlating with inflammatory activity. FDG-PET/CT can show increased FDG uptake in the patient’s peripheral paravertebral soft tissues, suggesting the presence of a soft tissue infection.FDG-PET/CT can help to differentiate between chronic osteomyelitis and implant infections, and also has high diagnostic accuracy in patients with metallic implants.FDG-PET/CT also has high sensitivity and accuracy in the diagnosis of postoperative patients. FDG-PET/CT can help to rule out other diseases such as malignant tumors |
| 18F-FDG – 18-fluorodeoxyglucose; PET – positron emission tomography; CT – computed tomography; MRI – magnetic resonance imaging; DCNN – deep convolutional neural networks; PPV – positive predictive value; NPV – negative predictive value. | |||||