Coincidence camera FDG imaging for the diagnosis of chronic orthopedic infections: A feasibility study

Purpose: Results of dedicated [F-18]fluoro-2-deoxy-D-glucose (FDG) PET imaging in patients with suspected orthopedic infections are promising. This study evaluates the feasibility of dual-head gamma-camera coincidence (DHC) imaging in this population. Method: Twenty-four patients, referred for the confirmation or exclusion of orthopedic infection, were prospectively studied with consecutive FDG-dedicated PET and FDG DHC imaging. Images were read by two blinded readers experienced with FDG PET and compared with the final diagnosis, obtained by microbiologic proof in 11 patients and clinical follow-up of at least 9 months in 13 patients. Results: Nine patients had osseous infection on final diagnosis. Sensitivity, specificity, and accuracy in this limited series were (Reader 1/Reader 2), respectively, 100/100, 86/86, and 92/92% for FDG-dedicated PET and 89/89, 100/93, and 96/92% for FDG DHC imaging. Conclusion: Despite lower image quality for FDG DHC imaging, results in this limited series were comparable with the results of FDG-dedicated PET. Further studies are needed to confirm the utility of FDG DHC imaging in suspected chronic orthopedic infections in larger patient groups.