TY - JOUR
T1 - A PET/CT approach to spinal cord metabolism in amyotrophic lateral sclerosis
AU - Marini, Cecilia
AU - Cistaro, Angelina
AU - Campi, Cristina
AU - Calvo, Andrea
AU - Caponnetto, Claudia
AU - Nobili, Flavio Mariano
AU - Fania, Piercarlo
AU - Beltrametti, Mauro C.
AU - Moglia, Cristina
AU - Novi, Giovanni
AU - Buschiazzo, Ambra
AU - Perasso, Annalisa
AU - Canosa, Antonio
AU - Scialò, Carlo
AU - Pomposelli, Elena
AU - Massone, Anna Maria
AU - Bagnara, Maria Caludia
AU - Cammarosano, Stefania
AU - Bruzzi, Paolo
AU - Morbelli, Silvia
AU - Sambuceti, Gianmario
AU - Mancardi, Gianluigi
AU - Piana, Michele
AU - Chiò, Adriano
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Purpose: In amyotrophic lateral sclerosis, functional alterations within the brain have been intensively assessed, while progression of lower motor neuron damage has scarcely been defined. The aim of the present study was to develop a computational method to systematically evaluate spinal cord metabolism as a tool to monitor disease mechanisms. Methods: A new computational three-dimensional method to extract the spinal cord from 18F-FDG PET/CT images was evaluated in 30 patients with spinal onset amyotrophic lateral sclerosis and 30 controls. The algorithm identified the skeleton on the CT images by using an extension of the Hough transform and then extracted the spinal canal and the spinal cord. In these regions, 18F-FDG standardized uptake values were measured to estimate the metabolic activity of the spinal canal and cord. Measurements were performed in the cervical and dorsal spine and normalized to the corresponding value in the liver. Results: Uptake of 18F-FDG in the spinal cord was significantly higher in patients than in controls (p < 0.05). By contrast, no significant differences were observed in spinal cord and spinal canal volumes between the two groups. 18F-FDG uptake was completely independent of age, gender, degree of functional impairment, disease duration and riluzole treatment. Kaplan-Meier analysis showed a higher mortality rate in patients with standardized uptake values above the fifth decile at the 3-year follow-up evaluation (log-rank test, p < 0.01). The independence of this value was confirmed by multivariate Cox analysis. Conclusion: Our computational three-dimensional method enabled the evaluation of spinal cord metabolism and volume and might represent a potential new window onto the pathophysiology of amyotrophic lateral sclerosis.
AB - Purpose: In amyotrophic lateral sclerosis, functional alterations within the brain have been intensively assessed, while progression of lower motor neuron damage has scarcely been defined. The aim of the present study was to develop a computational method to systematically evaluate spinal cord metabolism as a tool to monitor disease mechanisms. Methods: A new computational three-dimensional method to extract the spinal cord from 18F-FDG PET/CT images was evaluated in 30 patients with spinal onset amyotrophic lateral sclerosis and 30 controls. The algorithm identified the skeleton on the CT images by using an extension of the Hough transform and then extracted the spinal canal and the spinal cord. In these regions, 18F-FDG standardized uptake values were measured to estimate the metabolic activity of the spinal canal and cord. Measurements were performed in the cervical and dorsal spine and normalized to the corresponding value in the liver. Results: Uptake of 18F-FDG in the spinal cord was significantly higher in patients than in controls (p < 0.05). By contrast, no significant differences were observed in spinal cord and spinal canal volumes between the two groups. 18F-FDG uptake was completely independent of age, gender, degree of functional impairment, disease duration and riluzole treatment. Kaplan-Meier analysis showed a higher mortality rate in patients with standardized uptake values above the fifth decile at the 3-year follow-up evaluation (log-rank test, p < 0.01). The independence of this value was confirmed by multivariate Cox analysis. Conclusion: Our computational three-dimensional method enabled the evaluation of spinal cord metabolism and volume and might represent a potential new window onto the pathophysiology of amyotrophic lateral sclerosis.
KW - Amyotrophic lateral sclerosis
KW - Neuroimaging
KW - PET/CT
KW - Spinal cord
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U2 - 10.1007/s00259-016-3440-3
DO - 10.1007/s00259-016-3440-3
M3 - Article
C2 - 27421971
AN - SCOPUS:84978819076
VL - 43
SP - 2061
EP - 2071
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
IS - 11
ER -