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Chronic osteomyelitis: detection with FDG PET and correlation with histopathologic findings
A Guhlmann1, D Brecht-Krauss, G Suger
1Department of Radiology III, University of Ulm, Germany.
Radiology
|March 12, 1998
Summary
Positron emission tomography (PET) with 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) accurately detects chronic osteomyelitis. This imaging technique shows high sensitivity and specificity, especially in the central skeleton, aiding diagnosis.
Area of Science:
- Nuclear Medicine
- Radiology
- Orthopedic Surgery
Background:
- Chronic osteomyelitis is a challenging bone infection requiring accurate diagnostic tools.
- Conventional imaging modalities may have limitations in diagnosing chronic osteomyelitis, particularly in complex cases.
Purpose of the Study:
- To evaluate the diagnostic performance of 2-(fluorine-18) fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) for detecting chronic osteomyelitis.
- To assess the accuracy of FDG PET in both peripheral and central skeletal sites.
Main Methods:
- Prospective evaluation of 31 patients with suspected chronic osteomyelitis using FDG PET.
- Diagnosis confirmed by bacteriologic culture and histopathologic analysis.
- Receiver operating characteristic (ROC) curve analysis to determine diagnostic accuracy.
Main Results:
- FDG PET demonstrated high accuracy (97%) in diagnosing chronic osteomyelitis.
- Overall sensitivity was 100% and specificity was 92%.
- Area under the ROC curve was 0.96 for all patients, with excellent performance in the peripheral skeleton (1.00) and good performance in the central skeleton (0.88).
Conclusions:
- FDG PET is a highly accurate, noninvasive imaging modality for detecting and assessing the extent of chronic osteomyelitis.
- FDG PET shows particular promise for diagnosing chronic osteomyelitis in the central skeleton, including active bone marrow.