Article Figures & Data
Figures
- FIGURE 1.
Infected metatarsophalangeal prosthesis in 43-y-old woman with elevated CRP 14 mo after intervention. (A and B) 68Ga-pentixafor PET/CT shows elevated tracer uptake at infected prosthesis at right metatarsophalangeal joint I in transversal (A) and sagittal (B) views. (C) Transversal non–attenuation-corrected PET image also shows increased uptake around prosthesis, indicating that attenuation correction does not influence outcome of 68Ga-pentixafor PET/CT by mimicking increased tracer uptake. (D) Planar view of 111In-oxine scintigraphy 24 h after injection is negative for uptake.
- FIGURE 2.
Plasmocytoma in 62-y-old man with elevated CRP and suspected spondylodiskitis. (A and B) 68Ga-pentixafor (A) and 18F-FDG (B) PET/CT (sagittal view) shows increased tracer uptake in multiple vertebrae, with maximum in thoracic vertebrae 10 and 11. (C) MRI shows plasmocytoma in thoracic vertebrae 10 and 11.
- FIGURE 3.
Distinct osteomyelitis in 52-y-old patient with elevated CRP 5 mo after removal of total-knee arthroplasty and implantation of spacer. (A and B) Coronal (A) and sagittal (B) 68Ga-pentixafor PET/CT images show increased tracer uptake in tibia and femur, respectively, including bone marrow compartment. (C) Sagittal 99mTc-besilesomab scintigraphy image 4 h after injection shows osteitis without increased uptake in bone marrow.
- FIGURE 4.
Osteomyelitis of maxilla in 62-y-old woman 3 mo after intervention. (A–C) 68Ga-pentixafor PET/CT shows osteomyelitis of the maxilla on coronal (A), sagittal (B), and transversal (C) views. (D) Planar 111In-oxine scintigraphy image 24 h after injection shows physiologic tracer uptake.
Tables
Patient no. Sex Age (y) Diagnosis Proof SUVmax TBR CRP CRP FU 1 M 21 Osteitis, femur B 4.5 10.5 167 Neg 2 M 65 Osteomyelitis, tibia P 2.2 5.5 Neg Neg 3 M 77 Infected knee resurfacing B 3.9 4.3 Neg Neg 4 M 52 Osteomyelitis around knee spacer B 3.5 7 25.4 13.9 5 M 62 Necrotic plasmacytoma MRI, FU 3.6 7.2 10.7 12.1 6 F 43 Infected prosthesis, metatarsophalangeal FU 2.2 5.5 15 Neg 7 F 62 Osteomyelitis, maxillary P 3.7 7.4 Neg Neg 8 F 51 Septic loosening, knee endoprosthesis FU 2.9 7.3 13.3 Neg 9 F 73 Osteomyelitis, mandibular P 3.4 7.8 47.9 neg FU = follow-up; B = bacteriology; neg = negative; P = pathology.
Patient no. Sex Age (y) Proof SUVmax TBR CRP FU 1 F 61 Spondylodesis with broken screw FU Neg Neg 2 M 19 Postinterventional, mandible FU 11.4 Neg 3 F 75 Aseptic loosening, knee endoprosthesis FU Neg Neg 4 M 78 Spondylodesis with broken screw FU Neg Neg 5 F 48 Postinterventional, mandible FU Neg Neg FU = follow-up; neg = negative.
Pentixafor Result True/false? CT BS FDG Ind Besi MRI Proof Positive Patient 1 TP TP — TP — — FN B Patient 2 TP FN TP TP FN — — P Patient 3 TP FN TP — TP — — B Patient 4 TP FN TP — — TP — B Patient 5 FP FP — FP — — TP FU Patient 6 TP TP TP — FN — — FU Patient 7 TP FN TP — FN — — P Patient 8 TP FN TP — — — — FU Patient 9 TP TP TP — — — — P Negative Patient 1 TN TN FP TN — — — FU Patient 2 TN TN FP — — — — FU Patient 3 TN TN FP — TN — — FU Patient 4 TN TN — — — — — FU Patient 5 TN TN FP — TN — — FU Pentixafor = 68Ga-pentixafor PET/CT; BS = 3-phase bone scintigraphy; FDG = 18F-FDG PET/CT; Ind = 111In-oxine–labeled leukocyte scintigraphy; Besi = 99mTc-besilesomab; TP = true-positive; FN = false-negative; FP = false-positive; TN = true-negative; B = bacteriology; P = pathology; FU = follow-up.
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