Localization of dystonic muscles with 18F-FDG PET/CT in idiopathic cervical dystonia

Abstract

The purpose of this study was to investigate whether 18F-FDG PET/CT is useful for localizing dystonic cervical muscles in patients with idiopathic cervical dystonia (ICD) by comparing disease severity before and disease severity after botulinum toxin (BT) injection into hypermetabolic muscles. Methods: Six patients with ICD underwent 18F-FDG PET/CT. Dystonic muscles suitable for BT injection therapy were defined as those showing diffusely increased 18F-FDG uptake. Results: Hypermetabolic cervical muscles were identified in all 6 patients. In 2 patients who underwent PET/CT both in a supine position and in a sitting position during 18F-FDG uptake, abnormal hypermetabolic muscles were observed by PET/CT only when patients were in the sitting position with their heads and necks in the adopted abnormal involuntary posture. Symptoms were significantly improved in 4 patients who underwent BT injection therapy guided by PET/CT and who were clinically monitored. Conclusion: 18F-FDG PET/CT is potentially useful for identifying dystonic cervical muscles for BT therapy in patients with ICD. Copyright © 2007 by the Society of Nuclear Medicine, Inc.