An untapped potential for imaging of peripheral osteomyelitis in paediatrics using [ 18 F]FDG PET/CT —the inference from a juvenile porcine model
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An untapped potential for imaging of peripheral osteomyelitis in paediatrics using [ 18 F]FDG PET/CT —the inference from a juvenile porcine model. / Afzelius, P.; Nielsen, O. L.; Schønheyder, H. C.; Alstrup, A. K.O.; Hansen, S. B.
In: EJNMMI Research, Vol. 9, 29, 2019.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - An untapped potential for imaging of peripheral osteomyelitis in paediatrics using [ 18 F]FDG PET/CT —the inference from a juvenile porcine model
AU - Afzelius, P.
AU - Nielsen, O. L.
AU - Schønheyder, H. C.
AU - Alstrup, A. K.O.
AU - Hansen, S. B.
PY - 2019
Y1 - 2019
N2 - Purpose: To examine parameters affecting the detection of osteomyelitis (OM) by [ 18 F]FDG PET/CT and to reduce tracer activity in a pig model. Background: [ 18 F]FDG PET/CT is recommended for the diagnosis of OM in the axial skeleton of adults. In children, OM has a tendency to become chronic or recurrent, especially in low-income countries. Early diagnosis and initiation of therapy are therefore essential. We have previously demonstrated that [ 18 F]FDG PET/CT is promising in juvenile Staphylococcus aureus (S. aureus) OM of peripheral bones in a pig model, not failing even small lesions. When using imaging in children, radiation exposure should be balanced against fast diagnostics in the individual case. Methods: Twenty juvenile pigs were inoculated with S. aureus. One week after inoculation, the pigs were [ 18 F]FDG PET/CT scanned. PET list-mode acquired data of a subgroup were retrospectively processed in order to simulate and examine the image quality obtainable with an injected activity of 132 MBq, 44 MBq, 13.2 MBq, and 4.4 MBq, respectively. Results: All lesions were detected by [ 18 F]FDG PET and CT. Some lesions were very small (0.01 cm 3 ), and others were larger (4.18 cm 3 ). SUV max was higher when sequesters (p = 0.023) and fistulas were formed (p < 0.0001). The simulated data demonstrated that it was possible to reduce the activity to 4.4 MBq without compromising image quality in pigs. Conclusions: [ 18 F]FDG PET/CT localized even small OM lesions in peripheral bones. It was possible to reduce the injected activity considerably without compromising image quality, impacting the applicability of PET/CT in peripheral OM in children.
AB - Purpose: To examine parameters affecting the detection of osteomyelitis (OM) by [ 18 F]FDG PET/CT and to reduce tracer activity in a pig model. Background: [ 18 F]FDG PET/CT is recommended for the diagnosis of OM in the axial skeleton of adults. In children, OM has a tendency to become chronic or recurrent, especially in low-income countries. Early diagnosis and initiation of therapy are therefore essential. We have previously demonstrated that [ 18 F]FDG PET/CT is promising in juvenile Staphylococcus aureus (S. aureus) OM of peripheral bones in a pig model, not failing even small lesions. When using imaging in children, radiation exposure should be balanced against fast diagnostics in the individual case. Methods: Twenty juvenile pigs were inoculated with S. aureus. One week after inoculation, the pigs were [ 18 F]FDG PET/CT scanned. PET list-mode acquired data of a subgroup were retrospectively processed in order to simulate and examine the image quality obtainable with an injected activity of 132 MBq, 44 MBq, 13.2 MBq, and 4.4 MBq, respectively. Results: All lesions were detected by [ 18 F]FDG PET and CT. Some lesions were very small (0.01 cm 3 ), and others were larger (4.18 cm 3 ). SUV max was higher when sequesters (p = 0.023) and fistulas were formed (p < 0.0001). The simulated data demonstrated that it was possible to reduce the activity to 4.4 MBq without compromising image quality in pigs. Conclusions: [ 18 F]FDG PET/CT localized even small OM lesions in peripheral bones. It was possible to reduce the injected activity considerably without compromising image quality, impacting the applicability of PET/CT in peripheral OM in children.
KW - Children
KW - Dose reduction
KW - Juvenile pigs
KW - Osteomyelitis
KW - Staphylococcus aureus
KW - [ F]FDG PET/CT
U2 - 10.1186/s13550-019-0498-5
DO - 10.1186/s13550-019-0498-5
M3 - Journal article
C2 - 30903403
AN - SCOPUS:85063297994
VL - 9
JO - EJNMMI Research
JF - EJNMMI Research
SN - 2191-219X
M1 - 29
ER -
ID: 218394402