2-deoxy-2-[18F]fluoro-d-glucose PET Combined with Computed Tomography in Musculoskeletal and Spine Infections
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Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain
Published on: August 8, 2019
Aman Tilak1, Vidhya Kannappan1, Shruti Sharma1
1Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
2-deoxy-2-[18F]fluoro-d-glucose PET combined with computed tomography (18F-FDG-PET/CT) is an established, whole-body technique for musculoskeletal/spinal infections. Its high sensitivity, tomographic localization and relatively preserved interpretability in patients with metallic-implants make it especially useful in chronic/low-grade osteomyelitis, the instrumented/postoperative spine, and spondylodiscitis. Activated neutrophils, macrophages, and lymphocytes at sites of infection upregulate glucose-transporters and hexokinase, driving increased radiotracer uptake, independent of bone turnover and largely unaffected by metallic-hardware. Whole-body coverage detects synchronous foci in septic prosthetic-joint infection and maps multilevel/disseminated tuberculous spondylitis in endemic-regions such as India, guiding biopsy and enabling objective, serial treatment response monitoring. Its chief limitation is limited specificity.
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