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Localization of Dystonic Muscles with ¹⁸F-FDG PET/CT in Idiopathic Cervical Dystonia

¹ Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; ² Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; ³ Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; and ⁴ Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence: For correspondence or reprints contact: Joon Young Choi, MD, Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Korea. E-mail: jynm.choi{at}samsung.com

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.

Key Words: cervical dystonia • spasmodic torticollis • botulinum toxin • ¹⁸F-FDG PET/CT

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

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