The diagnostic value of [F-18]FDG PET for the detection of chronic osteomyelitis and implant-associated infection

Wenter, Vera; Müller, Jan-Phillip; Albert, Nathalie L. ; Lehner, Sebastian; Fendler, Wolfgang P.; Bartenstein, Peter; Cyran, Clemens C.; Friederichs, Jan; Militz, Matthias; Hacker, Marcus und Hungerer, Sven (2016): The diagnostic value of [F-18]FDG PET for the detection of chronic osteomyelitis and implant-associated infection. In: European Journal of Nuclear Medicine and Molecular Imaging, Bd. 43, Nr. 4: S. 749-761

Abstract

Purpose The diagnosis of osteomyelitis and implant-associated infections in patients with nonspecific laboratory or radiological findings is often unsatisfactory. We retrospectively evaluated the contributions of [F-18]FDG PET and [F-18]FDG PET/CT to the diagnosis of osteomyelitis and implant-associated infections, enabling timely and appropriate decision-making for further therapy options. Methods [F-18]FDG PET or PET/CT was performed in 215 patients with suspected osteomyelitis or implant-associated infections between 2000 and 2013. We assessed the diagnostic accuracy of both modalities together and separately with reference to intraoperative microbial findings, with a mean clinical follow-up of 69 +/- 49 months. Results Infections were diagnosed clinically in 101 of the 215 patients. PET and PET/CT scans revealed 87 true-positive, 76 true-negative, 38 false-positive, and 14 false-negative results, indicating a sensitivity of 86 %, a specificity of 67 %, a positive predictive value (PPV) of 70 %, a negative predictive value (NPV) of 84 % and an accuracy of 76 %. The sensitivity of PET/CT was 88 %, but specificity, PPV, NPV and accuracy (76 %, 76 %, 89 % and 82 %, respectively) were higher than those of stand-alone PET. Conclusion [F-18]FDG PET is able to identify with high sensitivity the presence of osteomyelitis in orthopaedic surgery patients with nonspecific clinical symptoms of infection.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1619-7070
• Sprache: Englisch