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Diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis

Hartmann, Anna ; Eid, Karim ; Dora, Claudio ; Trentz, Otmar ; von Schulthess, Gustav ; Stumpe, Katrin

In: European Journal of Nuclear Medicine and Molecular Imaging, 2007, vol. 34, no. 5, p. 704-714

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    Titre
    • Diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis
    Auteur
    • Hartmann, Anna. Department of Medical Radiology, Division of Nuclear Medicine, University Hospital, 8091, Zurich, Switzerland
    • Eid, Karim. Department of Surgery, Division of Trauma Surgery, University Hospital, Zurich, Switzerland
    • Dora, Claudio. Department of Orthopedic Surgery, Orthopedic University Hospital Balgrist, Zurich, Switzerland
    • Trentz, Otmar. Department of Surgery, Division of Trauma Surgery, University Hospital, Zurich, Switzerland
    • von Schulthess, Gustav. Department of Medical Radiology, Division of Nuclear Medicine, University Hospital, 8091, Zurich, Switzerland
    • Stumpe, Katrin. Department of Medical Radiology, Division of Nuclear Medicine, University Hospital, 8091, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Nuclear Medicine and Molecular Imaging, 2007, vol. 34, no. 5, p. 704-714. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:321834
    Summary
    Purpose: To retrospectively evaluate the diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis. Methods: Thirty-three partial body 18F-FDG PET/CT scans were performed in 33 patients with trauma suspected of having chronic osteomyelitis. In 10 and 23 patients, infection was suspected in the axial and appendicular skeleton, respectively. In 18 patients, PET/CT was performed in the presence of metallic implants. Histopathology or bacteriological culture was used as the standard of reference. For statistical analysis, sensitivity, specificity and accuracy were calculated in relation to findings of the reference standard. Results: Of 33 PET/CT scans, 17 were true positive, 13 true negative, two false positive and one false negative. Eighteen patients had chronic osteomyelitis and 15 had no osseous infection according to the reference standard. Sensitivity, specificity and accuracy for 18F-FDG PET/CT was 94%, 87% and 91% for the whole group, 88%, 100% and 90% for the axial skeleton and 100%, 85% and 91% for the appendicular skeleton, respectively. Conclusion: 18F-FDG PET/CT is a highly sensitive and specific method for the evaluation of chronic infection in the axial and appendicular skeleton in patients with trauma. PET/CT allows precise anatomical localisation and characterisation of the infectious focus and demonstrates the extent of chronic osteomyelitis with a high degree of accuracy