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Forecasting Outcomes Using PET Imaging for Cervical Spinal Cord Compression Patients

By MedImaging International staff writers
Posted on 19 Sep 2013

For patients with degenerative cervical myelopathy, imaging with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) could act as a marker for a potentially reversible phase of the disease in which considerable clinical improvement can be accomplished.

According to research published in the September 2013 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 disorder in which the spinal canal tapers in the neck. While many patients do not have symptoms, once symptoms appear, it typically is a sign of the presence of myelopathy. This compression can lead to progressive neurologic deficits, such as weakness, numbness, or tingling in a leg, foot, hand, or arm.

The investigators’ goal was to evaluate the regional alterations of glucose metabolism of the cervical spinal cord using 18F-FDG PET imaging. “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, from Institute of Neuroscience and Medicine, Research Center Jülich (Jülich, Germany), and department of neurology, University of Cologne (Germany); one of the lead researchers of the study. “In the present study, we present the results of preoperative magnetic resonance imaging [MRI] and 18F-FDG PET imaging and postoperative follow-up imaging 12 months after decompressive surgery. Imaging findings were correlated with the clinical outcome.”

Researchers saw two substantially different patterns of 18F-FDG uptake among the 20 study participants prior to surgery: about half of the patients had increased 18F-FDG uptake at the site of spinal cord compression and were categorized as myelopathy type 1, whereas the other half had inconspicuous 18F-FDG uptake and were classified as myelopathy type 2. Postoperatively, those with myelopathy type 1 had a marked decrease in 18F-FDG uptake, whereas myelopathy type 2 patients had only a moderate decline in uptake.

The overall outcome in myelopathy type 1 patients was encouraging, 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 Dr. 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. To stratify eligible patients for decompressive surgery, our findings may help to implement 18F-FDG PET investigations of the cervical spine in clinical routine.”

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68 (35.04753112793): SELECT fid FROM jos_deeppockets WHERE id=294748296 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294748296 AND published='1' LIMIT 1

69 (39.100646972656): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

70 (275.1350402832): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748296 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (273.9429473877): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748296 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (77.009201049805): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (87.02278137207): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (50.067901611328): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748296 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (67.949295043945): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748296 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (38.14697265625): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

105 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

106 (57.93571472168): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748296 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (55.789947509766): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748296 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (90.837478637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

109 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

110 (74.148178100586): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748296 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (519.0372467041): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748296 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (711.91787719727): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (426.05400085449): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (123.97766113281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

115 (126.12342834473): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

116 (144.95849609375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

117 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

118 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

119 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

120 (396.9669342041): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 22187.948226929): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (105.85784912109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

123 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

124 (440.12069702148): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748296 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748296 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 477122.06840515): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (86.069107055664): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (45.061111450195): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (58.174133300781): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (55.074691772461): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (52.928924560547): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (468.01567077637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (558.85314941406): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (321.86508178711): SELECT name FROM jos_deeppockets WHERE id=213

136 (41.007995605469): SELECT name FROM jos_deeppockets WHERE id=213

137 (555.99212646484): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (401.02005004883): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

140 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

141 (!!!!! 10804.891586304): TRUNCATE TABLE jos_trademed_module

142 (147.10426330566): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748296 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (81.062316894531): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748296 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (540.97175598145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (105.14259338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

147 (169.99244689941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

148 (!!!!! 1302.95753479): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (93.221664428711): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

150 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

151 (75.101852416992): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748296 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748296 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (51.021575927734): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

153 (79.154968261719): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

154 (72.002410888672): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (100.85105895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

156 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748296 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748296 AND published='1' LIMIT 1

157 (58.889389038086): select jos_twitters.link from jos_twitters where cat=10

158 (33.140182495117): select jos_facebook.link from jos_facebook where cat=10

159 (32.901763916016): select jos_google_plus.link from jos_google_plus where cat=10

160 (32.186508178711): select jos_linkedin.link from jos_linkedin where cat=10

161 (297.06954956055): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1382.1125030518): insert into jos_banners_delta values (14615,'2025-06-19 19:28:08','216.73.216.120','view'),(14202,'2025-06-19 19:28:08','216.73.216.120','view'),(14203,'2025-06-19 19:28:08','216.73.216.120','view')

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