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

• Published in: European 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
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2018; Springer Nature B.V
• Subjects: Abscesses; Bacteremia; Biocompatibility; Biomedical materials; Cardiology; Computed tomography; Diagnostic systems; Imaging; Infections; Magnetic resonance imaging; Medical diagnosis; Medical personnel; Medicine; Medicine & Public Health; Metastases; NMR; Nuclear magnetic resonance; Nuclear Medicine; Oncology; Original; Original Article; Orthopedics; Osteomyelitis; Patients; Physicians; Positron emission; Positron emission tomography; Radiology; Sensitivity; Tomography; Vertebrae; Vertebral osteomyelitis; F–Fdg-pet/ct; MRI; Vertebral osteomyelitis; Abscesses
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-017-3912-0

Purpose
The aim of this study was to determine the diagnostic value of
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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
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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.
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F–FDG-PET/CT and MRI were compared to the clinical diagnosis according to international guidelines.
Results
For
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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
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F–FDG-PET/CT is the detection of metastatic infection (16 patients, 50.0%).
Conclusion
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F–FDG-PET/CT and MRI are both necessary techniques in diagnosing vertebral osteomyelitis. An important advantage of
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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.