DOI: 10.1007/s00259-017-3912-0Pages: 1-8

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

1. Radboud University Medical Center, Department of Internal Medicine and Infectious Diseases

2. University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging Group

3. Leiden University Medical Center, Department of Internal Medicine and Infectious Diseases

4. Radboud University Medical Center, Department of Radiology and Nuclear Medicine

5. Leiden University Medical Center, Department of Radiology

6. University of Twente, Technical Medicine

7. Radboud University Medical Center, Department of Orthopedic Surgery

8. The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Department of Nuclear Medicine

Correspondence to:
Ilse J. E. Kouijzer
Tel: 0031-24-3618819
Email: ilse.kouijzer@radboudumc.nl

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Abstract

Purpose

The aim of this study was to determine the diagnostic value of 18F–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 18F–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. 18F–FDG-PET/CT and MRI were compared to the clinical diagnosis according to international guidelines.

Results

For 18F–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 18F–FDG-PET/CT is the detection of metastatic infection (16 patients, 50.0%).

Conclusion

18F–FDG-PET/CT and MRI are both necessary techniques in diagnosing vertebral osteomyelitis. An important advantage of 18F–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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  • Accepted: Dec 10, 2017
  • Online: Dec 19, 2017

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