The diagnostic value of 18F–FDG-PET/CT and MRI in suspected vertebral osteomyelitis – a prospective study

Purpose The aim of this study was to determine the diagnostic value of 18 F–fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) and magnetic resonance imaging (MRI) in diagnosing vertebral osteomyelitis. Methods From November 2015 until December 2016, 32 patients w...

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Published inEuropean journal of nuclear medicine and molecular imaging Vol. 45; no. 5; pp. 798 - 805
Main Authors Kouijzer, Ilse J. E., Scheper, Henk, de Rooy, Jacky W. J., Bloem, Johan L., Janssen, Marcel J. R., van den Hoven, Leon, Hosman, Allard J. F., Visser, Leo G., Oyen, Wim J. G., Bleeker-Rovers, Chantal P., de Geus-Oei, Lioe-Fee
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2018
Springer Nature B.V
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Summary:Purpose The aim of this study was to determine the diagnostic value of 18 F–fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) and magnetic resonance imaging (MRI) in diagnosing vertebral osteomyelitis. Methods From November 2015 until December 2016, 32 patients with suspected vertebral osteomyelitis were prospectively included. All patients underwent both 18 F–FDG-PET/CT and MRI within 48 h. All images were independently reevaluated by two radiologists and two nuclear medicine physicians who were blinded to each others’ image interpretation. 18 F–FDG-PET/CT and MRI were compared to the clinical diagnosis according to international guidelines. Results For 18 F–FDG-PET/CT, sensitivity, specificity, PPV, and NPV in diagnosing vertebral osteomyelitis were 100%, 83.3%, 90.9%, and 100%, respectively. For MRI, sensitivity, specificity, PPV, and NPV were 100%, 91.7%, 95.2%, and 100%, respectively. MRI detected more epidural/spinal abscesses. An important advantage of 18 F–FDG-PET/CT is the detection of metastatic infection (16 patients, 50.0%). Conclusion 18 F–FDG-PET/CT and MRI are both necessary techniques in diagnosing vertebral osteomyelitis. An important advantage of 18 F–FDG-PET/CT is the visualization of metastatic infection, especially in patients with bacteremia. MRI is more sensitive in detection of small epidural abscesses.
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ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-017-3912-0