title: Interest of [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography for the diagnosis of relapse in patients with spinal infection: a prospective study.
abstract: Relapse after treatment of a spinal infection is infrequent and difficult to diagnose. The aim of this study was to assess the diagnostic performance of [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in this setting. Thirty patients (21 men, nine women; median age 61.2 years) with a suspected spinal infection relapse were prospectively included between March 2010 and June 2013. The initial diagnosis of spinal infection was confirmed by positive bacterial cultures. The patients underwent [(18)F]FDG PET/CT and magnetic resonance imaging (MRI) 1 month after antibiotic treatment interruption. PET/CT data were interpreted both visually and semi-quantitatively (SUVmax). The patients were followed for ≥12 months and the final diagnosis of relapse was based on new microbiological cultures. Seven patients relapsed during follow up. Sensitivity, specificity, positive predictive value and negative predictive value were 66.6%, 61.9%, 33.3% and 86.6%, respectively for MRI and 85.7, 82.6, 60.0 and 95.0 for PET/CT. Although these values were higher for PET/CT than for MRI, the difference was not statistically significant (p=0.3). [(18)F]FDG PET/CT may be useful for diagnosing a relapse of spinal infections, in particular if metallic implants limit the performance of MRI.
authors.affiliation: Department of Infectious and Tropical Diseases, University Hospital of Bordeaux, Bordeaux, France. Electronic address: frederic.dauchy@chu-bordeaux.fr.
authors.forename: F-A
authors.initials: FA
authors.lastname: Dauchy
authors.affiliation: Department of Nuclear Medicine, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Dutertre
authors.affiliation: INSERM, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Lawson-Ayayi
authors.affiliation: Department of Nuclear Medicine, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: H
authors.initials: H
authors.lastname: de Clermont-Gallerande
authors.affiliation: Department of Diagnostic and Interventional Imaging, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Fournier
authors.affiliation: Department of Nuclear Medicine, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Zanotti-Fregonara
authors.affiliation: Department of Infectious and Tropical Diseases, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: H
authors.initials: H
authors.lastname: Dutronc
authors.affiliation: Spine Unit One, Orthopaedic Surgery, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Vital
authors.affiliation: Department of Infectious and Tropical Diseases, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Dupon
authors.affiliation: Department of Nuclear Medicine, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Fernandez
mesh_terms: D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000000981:diagnostic imaging*
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Diagnosis; PET/CT; implant; relapse; spinal infection