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

Abstract

The purpose of this study was to investigate whether (18)F-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. Six patients with ICD underwent (18)F-FDG PET/CT. Dystonic muscles suitable for BT injection therapy were defined as those showing diffusely increased (18)F-FDG uptake. 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 (18)F-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. (18)F-FDG PET/CT is potentially useful for identifying dystonic cervical muscles for BT therapy in patients with ICD.