Early dynamic 18F-FDG PET/CT to diagnose chronic osteomyelitis following lower extremity fractures

Stecker, F. F.; Schierz, Jan-Henning; Opfermann, Thomas; Driesch, Dominik; Hofmann, Gunther O.; Winkens, Thomas; Freesmeyer, Martin

doi:10.3413/nukmed-0572-13-03

Cited by 10 publications

(11 citation statements)

References 19 publications

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“…In line with the non-quantitative studies mentioned in the introduction, i.e. [4, 5, 7, 9, 10], we found increased blood perfusion in the OM lesions (Table 3), as well as in the ST lesions (Table 4). However, as hypothesized, we found a quite clear distinction between the OM lesions and the ST lesions as the increase was significantly higher in the infected soft tissues than in the osteomyelitic lesions.…”

Section: Discussionsupporting

confidence: 91%

“…The study did not report quantitative perfusion, though, but found PET/CT valuable as a tool in the assessment. Two recent papers describe experiences with dynamic PET/CT, using [ 18 F]NaF [9] or [ 18 F]FDG [10] as tracer; both studies reported increased standardized uptake values (SUV) in the volume of interest (VOI) positioned at the site of chronic OM infection.…”

Section: Introductionmentioning

confidence: 99%

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Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

et al. 2017

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BackgroundOsteomyelitis is a serious disease which can be difficult to treat despite properly instituted antibiotic therapy. This appears to be related at least partly to degraded vascularisation in the osteomyelitic (OM) lesions. Studies of perfusion in OM bones are, however, few and not quantitative. Quantitative assessment of perfusion could aid in the selection of therapy. A non-invasive, quantitative way to study perfusion is dynamic [15O]water positron emission tomography (PET). We aim to demonstrate that the method can be used for measuring perfusion in OM lesions and hypothesize that perfusion will be less elevated in OM lesions than in soft tissue (ST) infection. The study comprised 11 juvenile pigs with haematogenous osteomyelitis induced by injection of Staphylococcus aureus into the right femoral artery 1 week before scanning (in one pig, 2 weeks). The pigs were dynamically PET scanned with [15O]water to quantify blood perfusion. OM lesions (N = 17) in long bones were studied, using the left limb as reference. ST lesions (N = 8) were studied similarly.ResultsPerfusion was quantitatively determined. Perfusion was elevated by a factor 1.5 in OM lesions and by a factor 6 in ST lesions.ConclusionsBlood perfusion was successfully determined in pathological subacute OM lesions; average perfusion was increased compared to that in a healthy bone, but as hypothesized, the increase was less than in ST lesions, indicating that the infected bone has less perfusion reserve than the infected soft tissue.Electronic supplementary materialThe online version of this article (doi:10.1186/s13550-016-0251-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

et al. 2017

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“…This technique is similar to performing early whole-body softtissue imaging with 99m Tc-labeled diphosphonate bone scanning using a sweep protocol as a screening tool for sites of joint inflammation. The proposed technique is analogous to prior published work on 2-phase or 3-phase 18 F-FDG PET for chronic osteomyelitis (6). 18 F-FDG PET for imaging of osteomyelitis has been found to have excellent sensitivity and specificity for bone infection, with possibly even higher accuracy than the cur- rent gold standard radionuclide technique of 99m Tc-hexamethylpropyleneamine oxime-or 111 In-labeled white blood cell scintigraphy (7,8).…”

Section: Replymentioning

confidence: 81%

Reply: Regarding Dynamic Bone Imaging with ^99mTc-Labeled Diphosphonates and ¹⁸F-NaF: Mechanisms and Applications

Wong

Piert

2013

J Nucl Med

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“…More recently, early dynamic PET/CT using [ 18 F]NaF or [ 18 F]FDG has been tested in chronic osteomyelitis suggesting that data on the early radiotracer distribution may provide additional information than standard acquisition however results to be validated prospectively in larger trials [38,39].…”

Section: Bone Infections 211 Peripheral Bone Osteomyelitismentioning

confidence: 99%

“…Preliminary results with 99m Tc-ubiquicidin [29][30][31][32][33][34][35][36][37][38][39][40][41] have been reported in patients with suspected SD. The sensitivity and specificity for detecting SD were 100% and 87%, respectively with a positive predictive value of 95% and a negative predictive value of 100%.…”

Section: Spondylodiscitismentioning

confidence: 99%

Current Status of Molecular Imaging in Infections

Sollini

Lauri²,

Boni

et al. 2018

CPD

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There is an increased need to find non-invasive tools for early diagnosis and follow-up of infections. Nuclear medicine techniques may be used to diagnose, localize and evaluate the severity and the extent of infections before the occurrence of anatomical abnormalities. This review focuses on different approaches based on radiolabelled cells, peptides and antibodies or [18F]FDG to image infective diseases in agreement with what is being jointly evaluated by the European Association of Nuclear Medicine (EANM). This is particularly relevant, since the EANM has strated a wide program of collaboration with other European clinical societies to define common diagnostic flow-charts in many of these infective diseases. It emerges the role of radiolabelled WBC by SPECT/CT for prosthetic joint infections and of FDG by PET/CT for spondylodiscitis. Comparable values of accuracy have been described for WBC and FDG in the diagnosis of vascular fgraft infections, diabetic gfoot, endocarditis and peripheral bone osteomyelitis, with some exceptions.

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Early dynamic 18F-FDG PET/CT to diagnose chronic osteomyelitis following lower extremity fractures

Abstract: This pilot study suggests that edFDG-PET may offer a less time consuming add on to standard FDG-PET/CT while being equally accurate. The results should be validated prospectively in larger trials.

Cited by 10 publications

References 19 publications

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

Reply: Regarding Dynamic Bone Imaging with ^99mTc-Labeled Diphosphonates and ¹⁸F-NaF: Mechanisms and Applications

Current Status of Molecular Imaging in Infections

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Early dynamic 18F-FDG PET/CT to diagnose chronic osteomyelitis following lower extremity fractures

Abstract: This pilot study suggests that edFDG-PET may offer a less time consuming add on to standard FDG-PET/CT while being equally accurate. The results should be validated prospectively in larger trials.

Cited by 10 publications

References 19 publications

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

Blood perfusion in osteomyelitis studied with [15O]water PET in a juvenile porcine model

Reply: Regarding Dynamic Bone Imaging with 99mTc-Labeled Diphosphonates and 18F-NaF: Mechanisms and Applications

Current Status of Molecular Imaging in Infections

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Product

Resources

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Reply: Regarding Dynamic Bone Imaging with ^99mTc-Labeled Diphosphonates and ¹⁸F-NaF: Mechanisms and Applications