Diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis.
OBJECTIVE
To retrospectively evaluate the diagnostic value of (18)F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis.


METHODS
Thirty-three partial body (18)F-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 (18)F-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.


CONCLUSIONS
(18)F-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.
Hartmann
Anna
A
Department of Medical Radiology, Division of Nuclear Medicine, University Hospital, 8091, Zurich, Switzerland.
Eid
Karim
K
Department of Surgery, Division of Trauma Surgery, University Hospital, Zurich, Switzerland.
Dora
Claudio
C
Department of Orthopedic Surgery, Orthopedic University Hospital Balgrist, Zurich, Switzerland.
Trentz
Otmar
O
Department of Surgery, Division of Trauma Surgery, University Hospital, Zurich, Switzerland.
von Schulthess
Gustav K
GK
Department of Medical Radiology, Division of Nuclear Medicine, University Hospital, 8091, Zurich, Switzerland.
Stumpe
Katrin D M
KDM
Department of Medical Radiology, Division of Nuclear Medicine, University Hospital, 8091, Zurich, Switzerland. katrin.stumpe@usz.ch.
D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000473:pathology; D002908:Chronic Disease; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18