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Comparison of 18F-FDG and 68Ga PET imaging in the assessment of experimental osteomyelitis due to Staphylococcus aureus

  • Tatu J. Mäkinen
  • Petteri Lankinen
  • Tiina Pöyhönen
  • Jari Jalava
  • Hannu T. Aro
  • Anne RoivainenEmail author
Original Article

Abstract

Purpose

Although positron emission tomography (PET) using 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) is a promising imaging modality for bone infections, the technique may still give false-positive results due to unspecific uptake in healing bone. This experimental study compared 18F-FDG and 68Ga in PET imaging of osteomyelitis and normal bone healing.

Methods

A diffuse osteomyelitis model of the tibia was applied in the rat (n=50). Two weeks after operation, PET imaging with 18F-FDG and 68Ga was performed, followed by peripheral quantitative computed tomography (pQCT) and radiography. Osteomyelitis was verified by quantitative bacteriology. In addition to in vivo imaging, ex vivo measurements of tissue radioactivity were performed to verify uptake of the tracers.

Results

Compared with controls with normal bone healing, the osteomyelitic tibias showed increased SUV ratios (i.e. radioactivity ratios between the operated and non-operated sides) for both 18F-FDG (1.74±0.37) and 68Ga (1.62±0.28) (P<0.001). Ex vivo measurements also showed increased tracer accumulation in the infected bone (P=0.003 for 18F-FDG and P<0.001 for 68Ga). The intensity of 68Ga uptake reflected pathological changes of osteomyelitic bones measured by pQCT. The uptake of 18F-FDG, however, did not show as close a correlation with the anatomical changes. The healing bones without infection exhibited slightly elevated uptake of 18F-FDG (SUV ratio 1.16±0.06), but 68Ga did not accumulate in the healing bone, as judged on the basis of both in vivo imaging (SUV ratio 1.02±0.05) and ex vivo measurements (SUV 0.92±0.21) (P=0.003 and P=0.022 compared with 18F-FDG uptake, respectively).

Conclusion

This study suggests the feasibility of 68Ga PET imaging of bone infections. However, further studies are needed to clarify the value of 68Ga PET for clinical purposes.

Keywords

Infectious disease PET Osteomyelitis 18F-FDG 68Ga 

Notes

Acknowledgements

This work was funded by grants from the National Technology Agency of Finland (TEKES), Academy of Finland (grants No. 205757 and No. 103032), the Instrumentarium Foundation and the Finnish Cultural Foundation. T.J.M. and P.L. are PhD students supported by the Finnish Graduate School for Musculoskeletal Diseases. The authors thank Anni Virolainen-Julkunen, MD, PhD, for conducting the PFGE analysis and Tero Vahlberg, MSc, for statistical consultation.

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Tatu J. Mäkinen
    • 1
  • Petteri Lankinen
    • 1
  • Tiina Pöyhönen
    • 2
  • Jari Jalava
    • 3
  • Hannu T. Aro
    • 1
  • Anne Roivainen
    • 2
    Email author
  1. 1.Orthopaedic Research Unit, Department of Orthopaedic Surgery and TraumatologyUniversity of TurkuTurkuFinland
  2. 2.Turku PET CentreTurku University HospitalTurkuFinland
  3. 3.Department of Human Microbial Ecology and InflammationNational Public Health InstituteTurkuFinland

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