Radionuclide imaging of spinal infections

Abstract

In the future, PET-CT will likely provide more precise localisation of abnormalities. FDG-PET may prove to be useful for monitoring response to treatment in patients with spinal osteomyelitis. Other tracers for diagnosing spinal osteomyelitis are also under investigation, including radiolabelled antibiotics, such as 99mTc-ciprofloxacin, and radiolabelled streptavidin-biotin complex. Antimicrobial peptides display preferential binding to microorganisms over human cells and perhaps new radiopharmaceuticals will be recruited from the array of human antimicrobial peptides/proteins. In experiments with Tc-ubiquicidin-derived peptides, radioactivity at the site of infection correlated well with the number of viable bacteria present. Finally, radiolabelled antifungal tracers could potentially distinguish fungal from bacterial infections.

Prognostic Value of 18F-FDG PET in Monosegmental Stenosis and Myelopathy of the Cervical Spinal Cord

“…18 F-FDG PET has been used for more than 25 y in lesions of the spinal cord to differentiate between malignant neoplastic diseases (15)(16)(17)(18)(19)(20)(21)(22) and benign inflammatory lesions (23)(24)(25)(26). Myelopathy caused by degenerative compression, however, is a much more frequent clinical problem than inflammatory or neoplastic disorders of the cervical spine.…”

Clinical value of 2-deoxy-[18F]fluoro-d-glucose positron emission tomography in patients with cervical spondylotic myelopathy

“…Metabolic evaluation of spinal cord pathologies using 18 F-FDG PET has been performed for more than 25 years, especially in cases of neoplastic diseases 8,16,24,26,27,29,32,40 but also in a variety of cases involving benign inflammatory intraspinal lesions such as infections, 17 tophaceous gout, 33 and neurosarcoidosis. 10,31 In all of these space-occupying and compressive lesions, 18 F-FDG PET has been used to differentiate between benign and malignant pathologies or to monitor biological activity.…”

Osteomyelitis and Arthritis

“…111-Indium labeled leucocytes have a limited value in the diagnosis of spinal infection due to photopenic defects, which are unspecific as several non-infectious conditions (e.g. tumors and infarction) tend to show photopenia (29,30). Although most of the published series are small, FDG PET appears to be superior in the evaluation of spinal osteomyelitis with higher sensitivities and specificities compared to gallium 67-citrate imaging (31)(32)(33).…”