18F FDG PET-CT three-dimensional tool for localizing the exact location of the infected bone

Written By : Dr Supreeth D R |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-12-27T09:45:48+05:30 | Updated On 27 Dec 2022 11:36 AM IST

Osteomyelitis is a challenge in diagnosis and treatment. 18F-FDG PET-CT provides a non-invasive tool for diagnosing and localizing osteomyelitis with a sensitivity reaching 94% and specificity reaching 100%.

Ahmed Elsheikh et al conducted a study to assess the agreement in identifying the geographic area of infected bone and planned resection on plain X-ray versus 18F-FDG PET-CT. The study has been published in 'Indian Journal of Orthopaedics.'

Clinical photos and X-rays of ten osteomyelitis patients were shown to ten consultant surgeons; they were asked to draw the area of infection and extent of planned surgical debridement; data will be compared to 18F-FDG PET-CT results. The authors tested the agreement between the surgeons in every parameter.

Key findings of the study:

•The median years of experience of the included surgeons were three years and ranged from 1.5 to 6 years.

•The median annual infected cases treated by any surgeon were 28 (range 5 to 100 cases).

•The most common preferred tool for diagnosis was X-ray and CT together (50%).

•MRI was requested in 20% of cases, while the least frequent modality was CT alone (10%).

•The median circularity reading was significantly lower in X-ray (0.5) than 18F-FDG PET-CT (0.67) (p < 0.001).

•There was no correlation between any parameter and the years of experience ( p >0.05) nor the number of cases per year (p>0.05).

•Regarding height, there was poor agreement between surgeons.

•Regarding perimeter, the ten surgeons showed low-moderate agreement.

•The ten surgeons showed a low moderate agreement for circularity.

•Results document the variability of assessment and judgement based on plain X-rays.

•In comparison to PET-CT, All parameters were significantly different in favour of 18F-FDG PET-CT over X-ray (P<0.001).

The authors concluded that – "18F FDG PET-CT provides a three-dimensional tool for localizing the exact location of the infected bone and differentiating it from the normal bone. Thus, it could be beneficial in precise pre-operative planning and surgical debridement of chronic osteomyelitis."

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751