[FDG-PET for diagnosis and follow-up of inflammatory processes: initial results from the orthopedic viewpoint]

Abstract

Aim: The diagnosis and the assessment of osteomyelitis and spondylodiscitis can be difficult. The aim of this study was to evaluate the usefulness of FGD-PET in the detection of inflammatory processes.

Method: 23 orthopedic patients suspected of having peripheral osteomyelitis (n = 13) or spondylodiscitis (n = 10) were examined consecutively with FDG-PET. The FDG-PET scans were evaluated by the nuclear physicians in ignorance of the clinical diagnosis by visual interpretation, which was graded on a five-point scale (0 = no infection-4 = definitely infection).

Results: Of 23 patients, 15 had osteomyelitis (n = 8) or spondylodiscitis (n = 7). In these 15 cases, the FDG-PET was true-positive. The sensitivity was 100%. In the 8 cases without infection, the FDG-PET was in 5 cases true-negative and in 3 cases false-positive. Even with inlying metal implants, soft-tissue abscesses could be differentiated from the bony process.

Conclusion: The FDG-PET is a very sensitive procedure for the diagnosis of osteomyelitis and spondylodiscitis and for screening of inflammation foci. A further advantage is the high spatial solution. The quantification of the inflammatory activity allowed a monitoring of the therapy.