Role for positron emission tomography in skeletal diseases

Imaging plays a prominent role in the diagnosis and management of rheumatic diseases. Conventional imaging methods provide high-resolution structural information but usually fail to distinguish between active lesions and residual changes. Positron emission tomography (PET) with the tracer F-18-fluorodeoxyglucose (F-18-FDG) was recently introduced into clinical practice as a means of obtaining information on both structure and metabolic activity. F-18-FDG-PET is widely used in oncology and may be valuable in patients with infections or inflammatory diseases, most notably vasculitis. Although encouraging results have been published, the number of studies remains small, as F-18-FDG-PET is an expensive investigation that is not available everywhere. Further work is needed to determine the cost-effectiveness ratio of F-18-FDG-PET in patients with infections or inflammatory diseases. Imaging plays a prominent role in the diagnosis and management of many musculoskeletal diseases. Although considerable progress has been made recently, the structural information supplied by conventional imaging methods is inadequate in some patients. Positron emission tomography (PET) after injection of (18)fluorodeoxyglucose (F-18-FDG) provides information on tissue metabolism. The usefulness of F-18-FDG-PET in oncology is now widely recognized. Other uses are emerging, in part thanks to the development of new cameras that combine dedicated detectors and an X-scanner in order to ensure accurate three-dimensional localization of metabolically active lesions. However, the exact role for F-18-FDG-PET needs to be studied in larger populations of patients. (C) 2006 Elsevier Masson SAS. All rights reserved.