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Intrapatient Comparison of 2-Deoxy-2-[F-18]fluoro-d-glucose with Positron EmissionTomography/Computed Tomography to Tc-99m Fanolesomab (NeutroSpec) for Localization of Infection

Abstract

Purpose

This study evaluated the efficacy of 2-deoxy-2-[F-18]fluoro-d-glucose (FDG) with positron emission tomography/computed tomography (PET/CT) in comparison with Tc-99m fanolesomab (NeutroSpec) for imaging infection.

Procedures

Twelve patients with possible infection were studied with both FDG-PET/CT and Tc-99m fanolesomab. One patient was studied twice for a total of 13 paired studies. The final determination of the presence or absence of infection and the site(s) of infection at the time of imaging was made by an infectious disease physician using culture results and other relevant information. The sensitivity, specificity, and accuracy were calculated for each imaging study on a per paired study basis and a per lesion basis. In addition, the quality of lesion depicted was compared between the two studies.

Results

Three patients were determined not to have infection. Ten paired studies, in nine patients, were determined to have one or more sites of infection: seven had one site and three had two sites. On a per paired study basis the sensitivity, specificity, and accuracy of FDG-PET/CT were all 100%; for Tc-99m fanolesomab these parameters were 30, 100, and 46%, respectively (P < 0.01 for sensitivity and accuracy). On a per site basis the results for FDG-PET/CT were all 100% and for Tc-99m fanolesomab they were 23, 100, and 38% (P < 0.01 for sensitivity and accuracy). In the three sites of infection shown by both studies, FDG-PET/CT was judged to be superior in spatial resolution and anatomic localization compared to Tc-99m fanolesomab in all three sites.

Conclusion

FDG-PET/CT is superior to Tc-99m fanolesomab for detecting and localizing sites of infection.

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Fig. 1

References

  1. 1.

    Bleeker-Rovers CP, de Kleijn EMHA, Corstens FHM, et al. (2004) Clinical value of FDG PET in patients with fever of unknown origin and patients suspected of focal infection or inflammation. Eur J Nucl Med 31:29–37

  2. 2.

    Paik JY, Lee KH, Choe YS, et al. (2004) Augmented F-18-FDG uptake in activated monocytes occurs during the priming process and involves tyrosine kinases and protein kinase C. J Nucl Med 45:124–128

  3. 3.

    Zhuang H, Alavi A. (2002) 18-Fluorodeoxyglucose positron emission tomographic imaging in the detection and monitoring of infection and inflammation. Semin Nucl Med 32:47–59

  4. 4.

    Love C, Tomas MB, Tronco GG, et al. (2005) FDG PET of infection and inflammation. Radiographics 25:1357–1368

  5. 5.

    Meller J, Altenvoerde G, Munzel U, et al. (2000) Fever of unknown origin: Prospective comparison of F-18-FDG imaging with a double-head coincidence camera and gallium-67 citrate SPET. Eur J Nucl Med 27:1617–1625

  6. 6.

    Meller J, Koster G, Liersch T, et al. (2002) Chronic bacterial osteomyelitis: Prospective comparison of F-18-FDG imaging with a dual-head coincidence camera and In-111-labelled autologous leucocyte scintigraphy. Eur J Nucl Med 29:53–60

  7. 7.

    Stumpe KDM, Notzle HP, Zanetti M, et al. (2004) FDG PET for differentiation of infection and aseptic loosening in total hip replacements: Comparison with conventional radiography and three phase bone scintigraphy. Radiology 231:333–341

  8. 8.

    Makinen TJ, Lankinen P, Poyhonen T, et al. (2005) Comparison of F-18-FDG and Ga-68 PET imaging in the assessment of experimental osteomyelitis due to Staphylococcus aureus. Eur J Nucl Med 32:1259–1268

  9. 9.

    Sugawara Y, Gutowski TD, Fisher SJ, et al. (1999) Uptake of positron emission tomography tracers in experimental bacterial infections: A comparative biodistribution study of radiolabeled FDG, thymidine, l-methionine, Ga-67-citrate, and I-125-HSA. Eur J Nucl Med 26:333–341

  10. 10.

    Yeung HWD, Schoder H, Smith A, et al. (2005) Clinical value of combined positron emission tomography/computed tomography imaging in the interpretation of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography studies in cancer patients. Mol Imaging Biol 7:229–235

  11. 11.

    Kipper SL, Rypins EB, Evans DG, et al. (2000) Neutrophil-specific Tc-99m-labeled anti-CD15 monoclonal antibody imaging for diagnosis of equivocal appendicitis. J Nucl Med 41:449–455

  12. 12.

    FDA MedWatch (2005) Neutrospec (Technetium (99m Tc) fanolesomab): Marketing suspended effective immediately due to serious safety concerns. USA: FDA

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Acknowledgments

We are grateful to Samuel Wang, M.D., Keith C. Dangleis, M.D., and Orlin W. Hopper, M.D. for the original interpretation of several of the imaging studies and to Burton P. Golub, M.D. and Kathryn Springer, M.D. for assistance in accrual of two of the patients. We thank Mallinckrodt, Inc., St. Louis, MO, USA for providing the doses of Tc-99m NeutroSpec. The study was financially supported by Mallinckrodt, Inc.

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Correspondence to William C. Klingensmith III.

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Klingensmith, W.C., Perlman, D. & Baum, K. Intrapatient Comparison of 2-Deoxy-2-[F-18]fluoro-d-glucose with Positron EmissionTomography/Computed Tomography to Tc-99m Fanolesomab (NeutroSpec) for Localization of Infection. Mol Imaging Biol 9, 295–299 (2007). https://doi.org/10.1007/s11307-007-0097-0

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Key words

  • Infection
  • FDG
  • PET/CT
  • NeutroSpec
  • Imaging