Department of Nuclear Medicine, Rizhao People's Hospital, Rizhao, Shandong, China.
Department of Nuclear Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Immunol. 2023 Oct 5;14:1206682. doi: 10.3389/fimmu.2023.1206682. eCollection 2023.
The imaging diagnosis of fracture-related infection is often challenging. The aim of this study was to evaluate the value of F-FDG PET/CT for the diagnosis of fracture-related infection (FRI) with internal fixation after orthopedic surgery in lower extremities.
A total of 254 consecutive patients who underwent F-FDG PET/CT scans with suspected FRI with internal fixation in lower extremities were retrospectively investigated F-FDG PET/CT images were semiquantitatively evaluated with multiple metabolic parameters. Additionally, morphological information of the inguinal draining lymph nodes (DLN) with the highest SUV value was also collected and analyzed.
Patients were divided into two groups according to final diagnosis: the infected (N=197) and the non-infected group (N=57). The differences in the inguinal DLN-related parameters, including the long diameter, short diameter, maximum cross-sectional area, maximum standardized uptake value (SUVmax), metabolic volume (MV) 60%, MV70%, MV80%, total lesional glycolysis (TLG) 60%, TLG70%, TLG80%, and the infection suspected area related parameters, including SUVmax, MV25%, MV30%, MV35%, MV40%, MV50%, and TLG70%, between the two groups were statistically significant. We then compared the highest area under the curves (AUCs) among the morphological parameters of DLN, metabolic parameters of DLN, and metabolic parameters of the suspected infection area. The result demonstrated that SUVmax of the inguinal DLN showed the best diagnostic performance with an AUC of 0.939 (<0.05).
Semiquantitative analysis (especially SUVmax) of the inguinal DLN in F-FDG PET/CT images could be a promising method for the diagnosis of suspected FRI with internal fixation after orthopedic surgery in lower extremities.
骨折相关感染的影像学诊断常常具有挑战性。本研究旨在评估 F-FDG PET/CT 对下肢骨科内固定术后骨折相关感染（FRI）的诊断价值。
回顾性分析 254 例下肢内固定术后疑似 FRI 并接受 F-FDG PET/CT 检查的连续患者。对 F-FDG PET/CT 图像进行半定量评估，使用多个代谢参数。此外，还收集和分析了腹股沟引流淋巴结（DLN）中 SUV 值最高的形态学信息。
根据最终诊断，患者分为感染组（N=197）和非感染组（N=57）。两组腹股沟 DLN 相关参数存在差异，包括长径、短径、最大横截面积、最大标准化摄取值（SUVmax）、代谢体积（MV）60%、MV70%、MV80%、总病变糖酵解（TLG）60%、TLG70%、TLG80%和感染可疑区相关参数，包括 SUVmax、MV25%、MV30%、MV35%、MV40%、MV50%和 TLG70%，两组间差异有统计学意义。然后，我们比较了腹股沟 DLN 形态学参数、DLN 代谢参数和感染可疑区代谢参数中最高曲线下面积（AUC）。结果表明，腹股沟 DLN 的 SUVmax 诊断性能最佳，AUC 为 0.939（<0.05）。
F-FDG PET/CT 图像中腹股沟 DLN 的半定量分析（特别是 SUVmax）可能是一种有前途的方法，可用于诊断下肢骨科内固定术后疑似 FRI。
