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Using PET Scans to Diagnose Back Pain in Children

Finding the cause of back pain in children can be difficult. X-rays and other imaging studies may help. In this study, radiologists at Harvard Medical School compare two advanced imaging techniques. The cost, dose, and results of fluorine-18 sodium fluoride (18F NaF) PET scan were compared with technetium-99m (99mTc) scintigraphy.

Both methods use a radioactive dye called a tracer. The dye is injected into the blood stream through an intravenous (IV) line. A special gamma camera measures the amount of radiation emitted. The amount of dosage needed for both methods is about the same.

Fluoride PET scans have some potential advantages over scintigraphy. It has smaller-sized ions that can pass across the tiny blood vessels easier. The transfer of the ions is also faster. This means the imaging can begin much sooner (after 30 minutes instead of three hours).

The fluoride PET scan was used in a group of 94 young patients with low back pain. High radiotracer uptake was seen in more than half the patients. One-third of those children had a stress-induced injury to the supporting columns of the spine called the pedicles. Others had injury to the spinous process or the growth plate of the bone.

Although the fluoride PET scan costs more, the resolution was better. Improved image quality made it possible to diagnose and treat the patient sooner and save costs in the long-run.

In the past fluoride PET scans have been used successfully to identify bone cancer in the spine. This study shows it has equally effective uses in identifying orthopedic problems as well.

With today's time management issues, the significantly faster results with fluoride PET scan make it a very good choice. This is especially true with young children who can't hold still for three or four hours required for the scintigraphy test.

References: Ruth Lim, MD, et al. Early Experience with Fluorine-18 Sodium Fluoride Bone PET in Young Patients with Back Pain. In Journal of Pediatric Orthopaedics. April/May 2007. Vol. 27. No. 3. Pp. 277-282.

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