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Skeletal Radiol. 2017 Apr;46(4):533-538. doi: 10.1007/s00256-017-2587-8. Epub 2017 Feb 4.

Focal uptake at the rotator interval or inferior capsule of shoulder on 18F-FDG PET/CT is associated with adhesive capsulitis.

Author information

1
Department of Diagnostic Imaging, Universiti Kebangsaan Malaysia Medical Centre, JalanYaacob Latif, Cheras, 56000, Kuala Lumpur, Malaysia.
2
Department of Pain Medicine, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler, Unit 0409, Houston, TX, 77030, USA.
3
Department of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler, Unit 1475, Houston, TX, 77030, USA.
4
Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler, Unit 1411, Houston, TX, 77030, USA.
5
Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler, Unit 1411, Houston, TX, 77030, USA. bamini@mdanderson.org.

Abstract

OBJECTIVE:

To determine if focal increased uptake at the rotator interval (RI) and/or inferior capsule (IC) on18F-FDG PET/CT ("positive PET") predicts the presence of adhesive capsulitis (AC).

MATERIALS AND METHODS:

Three populations were retrospectively examined. Group 1 included 1,137 consecutive 18F-FDG PET/CT studies and was used to determine the prevalence of focal uptake at the RI or IC. Group 2 included 361 cases from a 10-year period with 18F-FDG PET/CT and MRI of shoulder performed within 45 days of each other and was used to enrich the study group. Group 3 included 109 randomly selected patients from the same time frame as groups 1 and 2 and was used to generate the control group. The study group consisted of 15 cases from the three groups, which had positive PET findings. PET/CT images were assessed in consensus by two musculoskeletal radiologists. The reference standard for a diagnosis of AC was clinical and was made by review of the medical record by a pain medicine physician.

RESULTS:

The prevalence of focal activity at either the RI or IC ("positive PET") was 0.53%. Nine patients had a clinical diagnosis of AC and 15 patients had a positive PET. The sensitivity and specificity of PET for detection of AC was 56% and 87%, respectively. PET/CT had a positive likelihood ratio for AC of 6.3 (95% CI: 2.8-14.6).

CONCLUSIONS:

Increased uptake at the RI or IC on PET/CT confers a moderate increase in the likelihood of AC.

KEYWORDS:

Adhesive capsulitis; FDG PET/CT; Inferior capsule; Rotator interval

PMID:
28161721
PMCID:
PMC5381154
DOI:
10.1007/s00256-017-2587-8
[Indexed for MEDLINE]
Free PMC Article

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