title: Early dynamic 18F-FDG PET/CT to diagnose chronic osteomyelitis following lower extremity fractures. A pilot study.
abstract: OBJECTIVE
  The study investigates whether early dynamic PET/CT (edPET/CT) using 18F-fluorodeoxyglucose (FDG) discriminates between affected versus non-affected sites in patients with complicated, protracted fracture healing and suspected COM in the lower extremities.
  
  
  METHODS
  In nine consecutive patients (1 woman, 8 men; age 54 ± 13 years), before standard late FDG-PET/CT, altogether 10 edFDG-PET/CT examinations were performed in list mode over 5 min starting with radiopharmaceutical injection. Eight consecutive time intervals (frames), four 15-s, then four 60-s, were reconstructed. For every patient, several volumes-of-interest were selected. To measure early FDG influx and accumulation, maximum and mean ed standardized uptake values (respectively, edSUVmax, edSUVmean) were calculated in each volume-of-interest during each frame. Results were compared between affected and non-affected (contralateral) bone.
  
  
  RESULTS
  Starting in the 31-45s frame, the affected bone area showed significantly higher edSUVmax and edSUVmean than did the healthy contralateral region. In conventional PET/CT, affected bone areas also significantly differed from non-affected contralateral regions.
  
  
  CONCLUSIONS
  This pilot study suggests that edFDG-PET may offer a less time consuming add on to standard FDG-PET/CT while being equally accurate. The results should be validated prospectively in larger trials.
authors.forename: F F
authors.initials: FF
authors.lastname: Stecker
authors.forename: J-H
authors.initials: JH
authors.lastname: Schierz
authors.forename: T
authors.initials: T
authors.lastname: Opfermann
authors.forename: D
authors.initials: D
authors.lastname: Driesch
authors.forename: G O
authors.initials: GO
authors.lastname: Hofmann
authors.forename: T
authors.initials: T
authors.lastname: Winkens
authors.affiliation: Dr. Martin Freesmeyer, Jena University Hospital, Clinic of Nuclear Medicine, Bachstraße 18, 07740 Jena, Germany, Tel. +49/(0)36 41/93 32 20; Fax +49/(0)36 41/93 32 44, E-mail: Martin.Freesmeyer@med.uni-jena.de, www.nuklearmedizin.uniklinik-jena.de.
authors.forename: M
authors.initials: M
authors.lastname: Freesmeyer
mesh_terms: D042241:Early Diagnosis; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D050723:Fractures, Bone / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007869:Leg Injuries / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D010019:Osteomyelitis / Q000175:diagnosis* / Q000209:etiology; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-fluorodeoxyglucose; Positron emission tomography; chronic osteomyelitis; computed tomography; diagnosis; early dynamic positron emission tomography; list mode