Afzelius P, Nielsen O L, Schønheyder H C, Alstrup A K O, Hansen S B
Department of Diagnostic Imaging, Section of Clinical Physiology and Nuclear Medicine, North Zealand Hospital, Dyrehavevej 29, 3400, Hillerod, Denmark.
Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark.
EJNMMI Res. 2019 Mar 22;9(1):29. doi: 10.1186/s13550-019-0498-5.
To examine parameters affecting the detection of osteomyelitis (OM) by [F]FDG PET/CT and to reduce tracer activity in a pig model.
[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 [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.
Twenty juvenile pigs were inoculated with S. aureus. One week after inoculation, the pigs were [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.
All lesions were detected by [F]FDG PET and CT. Some lesions were very small (0.01 cm), and others were larger (4.18 cm). SUV 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.
[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.
研究影响[F]FDG PET/CT检测骨髓炎（OM）的参数，并在猪模型中降低示踪剂活性。
[F]FDG PET/CT被推荐用于诊断成人中轴骨骼的OM。在儿童中，OM有发展为慢性或复发性的趋势，尤其是在低收入国家。因此，早期诊断和开始治疗至关重要。我们之前已经证明，[F]FDG PET/CT在猪模型中对外周骨的青少年金黄色葡萄球菌（S. aureus）性OM诊断很有前景，即使是小病变也不会漏诊。在儿童中使用成像时，应在个体病例中平衡辐射暴露与快速诊断。
20只幼年猪接种金黄色葡萄球菌。接种一周后，对猪进行[F]FDG PET/CT扫描。对一个亚组的PET列表模式采集的数据进行回顾性处理，以分别模拟和检查注射活性为132 MBq、44 MBq、13.2 MBq和4.4 MBq时可获得的图像质量。
所有病变均通过[F]FDG PET和CT检测到。一些病变非常小（0.01 cm），其他病变较大（4.18 cm）。形成死骨（p = 0.023）和瘘管（p < 0.0001）时，标准化摄取值（SUV）更高。模拟数据表明，在不影响猪图像质量的情况下，可将活性降低至4.4 MBq。
[F]FDG PET/CT可定位外周骨中即使很小的OM病变。在不影响图像质量的情况下，有可能大幅降低注射活性，这影响了PET/CT在儿童外周OM中的适用性。
