The diagnostic value of 18F–FDG-PET/CT and MRI in suspected vertebral osteomyelitis – a prospective study

Ilse J.E. Kouijzer* (Corresponding Author), Henk Scheper, Jacky W.J. de Rooy, Johan L. Bloem, Marcel J.R. Janssen, Leon van Den Hoven, Allard J.F. Hosman, Leo G. Visser, Wim J.G. Oyen, Chantal P. Bleeker-Rovers, Lioe Fee de Geus-Oei

*Corresponding author for this work

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Abstract

Purpose: The aim of this study was to determine the diagnostic value of 18F–fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) and magnetic resonance imaging (MRI) in diagnosing vertebral osteomyelitis. Methods: From November 2015 until December 2016, 32 patients with suspected vertebral osteomyelitis were prospectively included. All patients underwent both 18F–FDG-PET/CT and MRI within 48 h. All images were independently reevaluated by two radiologists and two nuclear medicine physicians who were blinded to each others’ image interpretation. 18F–FDG-PET/CT and MRI were compared to the clinical diagnosis according to international guidelines. Results: For 18F–FDG-PET/CT, sensitivity, specificity, PPV, and NPV in diagnosing vertebral osteomyelitis were 100%, 83.3%, 90.9%, and 100%, respectively. For MRI, sensitivity, specificity, PPV, and NPV were 100%, 91.7%, 95.2%, and 100%, respectively. MRI detected more epidural/spinal abscesses. An important advantage of 18F–FDG-PET/CT is the detection of metastatic infection (16 patients, 50.0%). Conclusion: 18F–FDG-PET/CT and MRI are both necessary techniques in diagnosing vertebral osteomyelitis. An important advantage of 18F–FDG-PET/CT is the visualization of metastatic infection, especially in patients with bacteremia. MRI is more sensitive in detection of small epidural abscesses.

Original languageEnglish
Pages (from-to)798-805
Number of pages8
JournalEuropean journal of nuclear medicine and molecular imaging
Volume45
Issue number5
DOIs
Publication statusPublished - May 2018

Keywords

  • UT-Hybrid-D
  • Abscesses
  • MRI
  • Vertebral osteomyelitis
  • F–Fdg-pet/ct

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