The value of FDG-PET and bone scintigraphy with SPECT in the primary diagnosis and follow-up of patients with chronic osteomyelitis of the mandible.
OBJECTIVE
To appraise the value of FDG-PET and bone scintigraphy using SPECT in the primary diagnosis and follow-up of patients with chronic osteomyelitis of the mandible (COM).


METHODS
In a prospective study the pattern of tracer uptake was investigated using 2 diagnostic methods in 42 patients. Results were compared with histology and radiographs as well as clinical and laboratory parameters.


RESULTS
The use of FDG-PET in the primary diagnosis of COM resulted in a sensitivity of 64% and a specificity of 77.7%. The sensitivity of SPECT was 84% and the specificity 33.3%. During the follow-up period of these patients the sensitivity of SPECT increased to 93.7%, while the specificity decreased (6.6%). The sensitivity and specificity of FDG-PET for this follow-up group were 62.5 and 80%, respectively.


CONCLUSIONS
Because of its high sensitivity, SPECT is vastly superior to other diagnostic methods in initiating treatment. In the follow-up period it might be replaced by FDG-PET, which reflects the disease course better and indicates the time of clinical remission.
Hakim
S G
SG
Department of Maxillofacial Surgery, University Hospital of Luebeck, Germany. Samer.Hakim@mkg-chir.mu-luebeck.de
Bruecker
C W R
CW
Jacobsen
H Ch
HCh
Hermes
D
D
Lauer
I
I
Eckerle
S
S
Froehlich
A
A
Sieg
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005188:False Negative Reactions; D005189:False Positive Reactions; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008334:Mandible / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000601:surgery; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18