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



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.


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.


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.


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

This is a preview of subscription content, access via your institution.

Fig. 1


  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

    Article  Google Scholar 

  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

    PubMed  CAS  Google Scholar 

  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

    PubMed  Article  Google Scholar 

  4. 4.

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

    PubMed  Article  Google Scholar 

  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

    PubMed  Article  CAS  Google Scholar 

  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

    Article  CAS  Google Scholar 

  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

    PubMed  Article  Google Scholar 

  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

    Article  Google Scholar 

  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

    PubMed  Article  CAS  Google Scholar 

  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

    PubMed  Article  Google Scholar 

  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

    PubMed  CAS  Google Scholar 

  12. 12.

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

    Google Scholar 

Download references


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.

Author information



Corresponding author

Correspondence to William C. Klingensmith III.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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).

Download citation

Key words

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