Introduction: 5-10% of systemic metastatic cancer leads to spinal metastases, and bone scan and MRI are readily used to detect the structural changes caused by the spinal metastases. PET scan, with the ability to detect the metabolic activity of cancer cells, can also be used for confirmation of spinal metastases diagnosis, and even for early detection of spinal metastases prior to the structural change. Few studies have shown the functional value of PET scan in guidance for radiation therapy. This retrospective study aims to analyze PET scan’s ability to detect spinal metastases with high metabolic activity and its translation as a guidance for palliative radiation therapy.
Methods: We conducted a retrospective analysis of 72 patients with metastatic spinal tumors treated at Virginia Hospital Center between 2002 and 2014. PET-CT was used to calculate SUV values for each patients’ spinal tumors. Patients were treated by means of fractionated stereotactic radiosurgery. Pain scores were assessed by Visual Analog Scale.
Results: Mean pain scores were decreased from 2.1 to 0.72 after treatment (P<0.05). SUV values correlated with reduction in pain, but did not reach statistically significance.
Conclusions: Stereotactic radiation offers durable pain relief in the treatment of metastatic spinal tumors. Calculating SUV values with PET-CT is a safe and reliable method to determine which spinal metastases may benefit from receiving radiotherapy. A larger look into this methodology is warranted.
Patient Care: Using PET-CT to optimize stereotactic radiation planning can maximize the palliative benefits of radiation for metastatic spine tumors. High-dose single treatments are optimal for pain relief, and SUV values may correspond with lesions which will benefit most from this modality of treatment.
Learning Objectives: By the conclusion of this session, participants should be able to: describe how PET-CT SUV values can be used as part of a pre-treatment assessment for palliative stereotactic radiosurgery for spinal metastases