PET/CT in musculoskeletal infection

Area of Science:

• Nuclear Medicine
• Radiology
• Orthopedics

Background:

• Early diagnosis of musculoskeletal infections is crucial for effective treatment and preventing complications.
• Fluorine-18 (F-18) fluorodeoxyglucose-positron emission tomography (FDG-PET) is emerging as a valuable imaging tool for these infections.
• FDG-PET is particularly useful for chronic osteomyelitis and spinal infections, and its utility is not affected by metallic artifacts unlike MRI and CT.

Purpose of the Study:

• To review the current literature on the use of FDG-PET/CT in diagnosing musculoskeletal infections.
• To evaluate the role of FDG-PET/CT in both acute and chronic skeletal infections.
• To discuss the advantages of FDG-PET/CT, especially in patients with metallic implants.

Main Methods:

• Review of existing scientific literature on FDG-PET/CT for musculoskeletal infections.
• Analysis of FDG-PET/CT performance in diagnosing axial and appendicular skeletal infections.
• Comparison of FDG-PET/CT with other imaging modalities like MRI, CT, and scintigraphy.

Main Results:

• FDG-PET/CT demonstrates promising results for diagnosing both acute and chronic musculoskeletal infections.
• PET imaging is advantageous in patients with metallic implants where MRI and CT can be limited by artifacts.
• While FDG-PET/CT offers improved accuracy, especially when combined with CT for anatomical correlation, results for prosthetic joint infections remain controversial, with scintigraphy still considered the gold standard.

Conclusions:

• FDG-PET/CT is a valuable imaging modality for diagnosing musculoskeletal infections, offering improved accuracy and utility in specific patient populations.
• The choice of imaging method, including FDG-PET/CT, depends on factors such as cost, availability, and clinical context.
• Further research may clarify the role of FDG-PET/CT in prosthetic joint infections and other complex cases.