Early detection of bone infection and differentiation from post-surgical inflammation using 2-deoxy-2-[18F]-fluoro-D-glucose positron emission tomography (FDG-PET) in an animal model.
Diagnosing bone infection in the context of post-surgical inflammation is problematic since many of the early signs of infection are similar to normal post-surgical changes. We used a rabbit osteomyelitis model to evaluate the use of 2-deoxy-2-[(18)F]-fluoro-d-glucose positron emission tomography (FDG-PET) as a means of detecting post-operative infection in the context of post-surgical inflammation. Comparisons were made between infected and non-infected rabbits in which infection with Staphylococcus aureus was initiated at the time of surgery. Weekly PET scans were obtained 30 and 60 min after the introduction of FDG and analyzed based on standardized uptake values (SUV) at the surgical site and visual assessment of the presence or absence of infection. Concurrent X-rays were taken immediately prior to scanning. At 4weeks post-operatively, animals were sacrificed for histologic and bacteriologic confirmation of infection. Uptake of FDG was evident in the bone of all rabbits on day 1 post-surgery, however, SUV comparisons from the surgical site could not be used to distinguish between the infected and uninfected groups until day 15. Visual analysis of FDG-PET scans revealed a significant difference (p<0.01) between the infected and uninfected groups as early as day 8. This was due in part to the ability to visualize regional lymph nodes by FDG-PET.
Jones-Jackson
Laurie
L
Department of Radiology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA.
Walker
Ronald
R
Purnell
Gary
G
McLaren
Sandra G
SG
Skinner
Robert A
RA
Thomas
J Roby
JR
Suva
Larry J
LJ
Anaissie
Elias
E
Miceli
Marisa
M
Nelson
Carl L
CL
Ferris
Ernest J
EJ
Smeltzer
Mark S
MS
D000818:Animals; D004195:Disease Models, Animal; D019788:Fluorodeoxyglucose F18; D007249:Inflammation / Q000000981:diagnostic imaging*; D008297:Male; D010019:Osteomyelitis / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011817:Rabbits; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging*
D019788:Fluorodeoxyglucose F18