FDG-PET is highly accurate for the diagnosis of chronic osteomyelitis

Abstract

41

Objectives: Clinical diagnosis of chronic osteomyelitis is often difficult and often poses challenge to physicians. Recent studies have shown that FDG-PET can be utilized in the evaluation of a variety of inflammatory and infectious processes. In this study, the potentials of FDG PET in the diagnosis of chronic osteomyelitis were assessed.

Methods: The analysis included 57 patients with suspected osteomyelitis who underwent FDG PET imaging. All PET images were acquired in dedicated full-ring PET scanners. The findings from FDG PET images were compared with the final diagnosis. Final diagnosis was made on the basis of surgical findings, microbiology, and clinical follow-up.

Results: FDG PET correctly diagnosed the presence or absence of osteomyelitis in 53 of 57 patients. Twenty-seven had chronic osteomyelitis and 30 proved to be free of bone infection. FDG PET correctly identified 26 of 27 patients with chronic osteomyelitis but proved to be false-positive in 3. This study had a sensitivity rate of 96.3%, a specificity rate of 90.0%, and an accuracy rate of 93.0% in the evaluation of osteomyelitis. The positive and negative predictive value for PDG PET in the diagnosis of chronic osteomyelitis is 90.0% and 96.4%, respectively.

Conclusions: FDG PET is a highly effective imaging method for determining the presence or absence of chronic osteomyelitis and should be employed on the study of choice in this setting.