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. 2010 Apr;44(1):33-8.
doi: 10.1007/s13139-009-0004-5. Epub 2010 Feb 26.

Comparison between (18)F-FDG PET/CT and EMG Mapping for Identifying Dystonic Superficial Muscles in Primary Cervical Dystonia: Preliminary Results

Su Jin Jang  1 , Joon Young Choi  2 , Duk Hyun Sung  3 , Kwang Hong Park  3 , Ji Young Lee  2 , Sook Kyung Cho  2 , Jang Yu  2 , Kyung-Han Lee  2 , Byung-Tae Kim  2
Affiliations

Comparison between (18)F-FDG PET/CT and EMG Mapping for Identifying Dystonic Superficial Muscles in Primary Cervical Dystonia: Preliminary Results

Su Jin Jang et al. Nucl Med Mol Imaging. 2010 Apr.

Abstract

Purpose: This study was conducted to compare (18)F-FDG PET/CT and electromyography (EMG) mapping in patients with primary cervical dystonia (PCD) to find dystonic superficial cervical muscles.

Methods: Ten consecutive patients with PCD (M:F = 5:5, age 44 ± 13 years) whose dystonic posture was not relieved with conventional muscle relaxant therapy were included. Target cervical muscles for the comparison between (18)F-FDG PET/CT and EMG mapping were four representative superficial bilateral cervical muscles: splenius capitis muscle, sternocleidomstoid muscle, upper trapezius muscle, and leavator scapulae muscle. The diagnostic efficacy was compared between (18)F-FDG PET/CT and EMG mapping using physical exam and measurement of rotation angle as the gold standard.

Results: Among 80 muscles evaluated, there were 21 (26%) dystonic superficial cervical muscles assessed with physical exam and motion analysis. The sensitivity, specificity, and accuracy for localizing dystonic muscles were 76, 92, and 88% for (18)F-FDG PET/CT, and 95, 66, and 74% for EMG mapping, respectively. The sensitivity of EMG mapping was significantly higher than that of (18)F-FDG PET/CT. In contrast, (18)F-FDG PET/CT was significantly superior to EMG mapping for specificity and accuracy.

Conclusions: (18)F-FDG PET/CT is more specific and accurate than EMG mapping for finding superficial dystonic cervical muscles. The high sensitivity of EMG mapping suggests that (18)F-FDG PET/CT and EMG mapping are complementary for finding dystonic superficial cervical muscles.

Keywords: 18F-FDG; Electromyography; PET/CT; Primary cervical dystonia; Spasmodic torticollis.

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Figures

Fig. 1
Fig. 1
Measurement of rotation angle in dystonic posture. Six light-reflecting markers were located on the anterior/posterior and left/right sides of a helmet and on both acromioclavicular joints. The rotation angle was defined as the angle between the line connecting markers on bilateral acromioclavicular joints and the line connecting the anterior and posterior helmet markers
Fig. 2
Fig. 2
Maximum intensity projection volume-rendering PET image of a 30-year-old male patient with right PCD. Hypermetabolism was found in right splenius capitis muscle, right levator scapulae muscle, left trapezius muscle, and bilateral sternocleidomastoid muscles. All hypermetabolic muscles were dystonic based on physical exam and measurement of rotation angle
See this image and copyright information in PMC

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