title: (18)F-FDG microPET imaging differentiates between septic and aseptic wound healing after orthopedic implant placement: a longitudinal study of an implant osteomyelitis in the rabbit tibia.
abstract: OBJECTIVE
  (18)F-FDG PET is a widely used tool for molecular imaging of oncological, cardiovascular, and neurological disorders. We evaluated (18)F-FDG microPET as an implant osteomyelitis imaging tool using a Staphylococcus aureus-induced peroperative implant infection in rabbits.
  
  
  METHODS
  Intramedullary titanium nails were implanted in contaminated and uncontaminated (control) proximal right tibiae of rabbits. Tibiae were quantitatively assessed with microPET for (18)F-FDG uptake before and sequentially at 1, 3, and 6 weeks after surgery. Tracer uptake was assessed in soft tissue and bone in both treatment groups with an additional comparison between the operated and unoperated limb. MicroPET analysis was combined with radiographic assessment and complementary histology of the tibiae.
  
  
  RESULTS
  At the first postoperative week, the (18)F-FDG uptake in the contaminated implant group was significantly higher than the preoperative measurement, without a significant difference between the contaminated and uncontaminated tibiae. From the third postoperative week onward, (18)F-FDG uptake allowed discrimination between osteomyelitis and postoperative aseptic bone healing, as well as quantification of the infection at distinct locations around the implant.
  
  
  CONCLUSIONS
  (18)F-FDG-based microPET imaging allows differentiation between deep infection and undisturbed wound healing after implantation of a titanium intramedullary nail in this rabbit model. Furthermore, our results indicate that (18)F-FDG PET may provide a tool in human clinical diagnostics and for the evaluation of antimicrobial strategies in animal models of orthopedic implant infection.
authors.affiliation: Laboratory for Experimental Orthopaedics, Department of Orthopaedic Surgery , CAPHRI School for Public Health and Primary Care.
authors.forename: Jim C E
authors.initials: JC
authors.lastname: Odekerken
authors.forename: Boudewijn T
authors.initials: BT
authors.lastname: Brans
authors.forename: Tim J M
authors.initials: TJ
authors.lastname: Welting
authors.forename: Geert H I M
authors.initials: GH
authors.lastname: Walenkamp
mesh_terms: D000818:Animals; D001858:Bone Nails; D003937:Diagnosis, Differential; D004195:Disease Models, Animal; D005260:Female; D019788:Fluorodeoxyglucose F18; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation; D008137:Longitudinal Studies; D010019:Osteomyelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D049268:Positron-Emission Tomography / Q000379:methods*; D011817:Rabbits; D018805:Sepsis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013977:Tibia / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000503:physiopathology; D013997:Time Factors; D014025:Titanium; D014945:Wound Healing / Q000502:physiology*
chemical_list: D019788:Fluorodeoxyglucose F18; D014025:Titanium