Advertisement

Infectious and Inflammatory Diseases

  • Christopher J. Palestro
  • Zohar Keidar
  • Charito Love
Chapter

Abstract

The detection and localization of inflammation and infection with nuclear medicine techniques has been studied for nearly half a century. The most commonly performed procedures are bone (for osteomyelitis),67Ga citrate, and in vitro labeled leukocyte imaging. PET imaging with 18F-FDG also has proved to be useful, and its role in imaging inflammation and infection will undoubtedly increase in the future. Radiotracers, regardless of whether they are single photon or positron-emitting agents, primarily reflect function; only gross anatomic details can be inferred from radionuclide images. The fine anatomic detail that can be critical to differentiating physiologic from pathologic processes often is lacking. Integrating radionuclide and anatomic images can significantly improve diagnostic confidence and test accuracy.

Keywords

Positron Emission Tomography Fasting Blood Glucose Level Maximum Standardize Uptake Value Skeletal Scintigraphy Prosthetic Vascular Graft Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Bunyaviroch T, Aggarwal A, Oates ME. Optimized scintigraphic evaluation of infection and inflammation: role of single-photon emission computed tomography/computerized tomography fusion imaging. Sem Nucl Med 2006; 36:295–311.CrossRefGoogle Scholar
  2. 2.
    Palestro CJ, Love C. Radionuclide imaging of musculoskeletal infection: coventional agents. Semin Musculoskelet Radiol 2007;11:335–352.CrossRefPubMedGoogle Scholar
  3. 3.
    Love C, Palestro CJ. Radionuclide imaging of infection. J Nucl Med Tech 2004;32:47–57.Google Scholar
  4. 4.
    Love C, Tomas MB, Tronco GG, Palestro CJ. Imaging infection and inflammation with 18F-FDG-PET. RadioGraphics 2005;25:1357–1368.CrossRefPubMedGoogle Scholar
  5. 5.
    Vos FJ, Bleeker-Rovers CP, Corstens FH, Kullberg BJ, Oyen WJ.FDG-PET for imaging of non-osseous infection and inflammation. Q J Nucl Med Mol Imag 2006;50:121–130.Google Scholar
  6. 6.
    Strobel K, Stumpe KD. PET/CT in musculoskeletal infection. Semin Musculoskelet Radiol 2007;11:353–364.CrossRefGoogle Scholar
  7. 7.
    Bleeker-Rovers CP, Vos FJ, Corstens FH, Oyen WJ. Imaging of infectious diseases using [18F] fluorodeoxyglucose PET. Q J Nucl Med Mol Imaging 2008;52:17–29.PubMedGoogle Scholar
  8. 8.
    Bar-Shalom R, Yefremov N, Guralnik L, Keidar Z, Engel A, Nitecki S, Israel O. SPECT/CT using 67Ga and 111In-labeled leukocyte scintigraphy for diagnosis of infection. J Nucl Med 2006; 47:587–594.PubMedGoogle Scholar
  9. 9.
    Moschilla G, Thompson J, Turner JH. Co-registered Gallium-67 SPECT/CT imaging in the diagnosis of infection and monitoring treatment. World J Nucl Med 2006; 5:32–39.Google Scholar
  10. 10.
    Horger M, Eschmann SM, Pfannenberg C, Storek D, Vonthein R, Claussen CD, Bares R. Added value of SPECT/CT in patients suspected of having bone infection: preliminary results. Arch Orthop Trauma Surg 2007;127:211–221.CrossRefPubMedGoogle Scholar
  11. 11.
    Filippi L, Schillaci O. Tc-99m HMPAO-labeled leukocyte scintigraphy for bone and joint infections. J Nucl Med 2006;47:1908–1913.PubMedGoogle Scholar
  12. 12.
    Horger M, Eschmann SM, Pfannenberg C, Storek D, Vonthein R, Dammann F, Claussen CD, Bares R. The value of SPET/CT in chronic osteomyelitis. Eur J Nucl Med Mol Imaging 2003;30:1665–1673.CrossRefPubMedGoogle Scholar
  13. 13.
    Höpfner S, Krolak C, Kessler S, Tiling R, Brinkbäumer K, Hahn K, Dresel S. Preoperative imaging of Charcot neuroarthropathy in diabetic patients: comparison of ring PET, hybrid PET, and magnetic resonance imaging. Foot Ankle Int 2004;25:890–895.PubMedGoogle Scholar
  14. 14.
    Schwegler B, Stumpe KD, Weishaupt D, Strobel K, Spinas GA, von Schulthess GK, Hodler J, Böni T, Donath MY. Unsuspected osteomyelitis is frequent in persistent diabetic foot ulcer and better diagnosed by MRI than by 18F-FDG PET or 99mTc-MOAB. J Intern Med 2008;263:99–106.PubMedGoogle Scholar
  15. 15.
    Keidar Z, Militianu D, Melamed E, Bar-Shalom R, Israel O. The diabetic foot: initial experience with 18F-FDG-PET/CT. J Nucl Med 2005;46:444–449.PubMedGoogle Scholar
  16. 16.
    Keidar Z, Engel A, Nitecki S, Bar SR, Hoffman A, Israel O. PET/CT using 2-deoxy-2-[18F]fluoro-D-glucose for the evaluation of suspected infected vascular graft. Mol Imaging Biol 2003;5:23–25.CrossRefPubMedGoogle Scholar
  17. 17.
    Fukuchi K, Ishida Y, Higashi M, Tsunekawa T, Ogino H, Minatoya K, Kiso K, Naito H. Detection of aortic graft infection by fluorodeoxyglucose positron emission tomography: comparison with computed tomographic findings. J Vasc Surg 2005;42:919–925.CrossRefPubMedGoogle Scholar
  18. 18.
    Keidar Z, Engel A, Hoffman A, Israel O, Nitecki S. Prosthetic vascular graft infection: the role of 18F-FDG-PET/CT. J Nucl Med 2007; 48:1230–1236.CrossRefPubMedGoogle Scholar
  19. 19.
    Lorenzen J, Buchert R, Bohuslavizki KH. Value of FDG PET in patients with fever of unknown origin. Nucl Med Commun 2001;22:779–783.CrossRefPubMedGoogle Scholar
  20. 20.
    Blockmans D, Knockaert D, Maes A. De Caestecker J, Stroobants S, Bobbaers H, Mortelmans L. Clinical Value of [18 F]fluoro-deoxyglucose positron emission tomography for patients with fever of unknown origin. Clin Infect Dis 2001;32:191–196.CrossRefPubMedGoogle Scholar
  21. 21.
    Meller J, Altenvoerde G, Munzel U, Jauho A, Behe M, Gratz S, Luig H, Becker W. Fever of unknown origin: prospective comparison of [18F]FDG imaging with a double-head coincidence camera and 67Ga citrate SPET. Eur J Nucl Med 2000;27:1617–1625.CrossRefPubMedGoogle Scholar
  22. 22.
    Bleeker-Rovers CP, de Kleijn EMHA, Corstens FHM, van der Meer JWM, Oyen WJG. Clinical Value of FDG PET in patients with fever of unknown origin and patients suspected of focal infection or inflammation. Eur J Nucl Med Mol Imaging 2004; 31:29–37.CrossRefPubMedGoogle Scholar
  23. 23.
    Bleeker-Rovers CP, Vos FJ, de Kleijn EM, Mudde AH, Dofferhoff TS, Richter C, Smilde TJ, Krabbe PF, Oyen WJ, van der Meer JW. A prospective multicenter study on fever of unknown origin: the yield of a structured diagnostic protocol. Medicine 2007;86:26–38.CrossRefPubMedGoogle Scholar
  24. 24.
    Zhuang H, Sam JW, Chacko TK, Duarte PS, Hickeson M, Feng Q, Nakhoda KZ, Guan L, Reich P, Altimari SM, Alavi A. Rapid normalization of osseous FDG uptake following traumatic or surgical fractures. Eur J Nucl Med Mol Imaging 2003;30:1096–1103.CrossRefPubMedGoogle Scholar
  25. 25.
    De Winter F, Van de Wiele C, Vogelaers D, De Smet K, Verdonk R, Dierckx RA. Flourine –18 flourodeoxyglucose-positron emission tomography: a highly accurate imaging modality for the diagnosis of chronic musculoskeletal infections. J Bone Joint Surg 2001;83-A:651–660.PubMedGoogle Scholar
  26. 26.
    Guhlmann A, Brecht-Krauss D, Suger G, Glatting G, Kotzerke J, Kinzl L, Reske SN.Chronic osteomyelitis: detection with FDG PET and correlation with histopathologic findings. Radiology 1998;206:749–754.PubMedGoogle Scholar
  27. 27.
    Hartmann A, Eid K, Dora C, Trentz O, von Schulthess GK, Stumpe KDM. Diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis. Eur J Nucl Med Mol Imaging 2007;34:704–714.CrossRefPubMedGoogle Scholar
  28. 28.
    Palestro CJ, Love C, Miller TT. Imaging of musculoskeletal infections. Best Practice & Research. Clin Rheumatol 2006;20:1197–1218.Google Scholar
  29. 29.
    Stumpe KD, Zanetti M, Weishaupt D, Hodler J, Boos N, von Schulthess GK. FDG positron emission tomography for differentiation of degenerative and infectious endplate abnormalities in the lumbar spine detected on MR imaging. Am J Roentgenol 2002; 179:1151–1157.Google Scholar
  30. 30.
    Gratz S, Dorner J, Fischer U, Behr TM, Béhé M, Altenvoerde G, Meller J, Grabbe E, Becker W.18F-FDG hybrid PET in patients with suspected spondylitis. Eur J Nucl Med Mol Imaging 2002; 29:516–524.CrossRefPubMedGoogle Scholar
  31. 31.
    De Winter F, Gemmel F, Van de Wiele C, Poffijn B, Uyttendaele D, Dierckx R. 18-fluorine fluorodeoxyglucose positron emission tomography for the diagnosis of infection in the postoperative spine. Spine 2003;28:1314–1319.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Christopher J. Palestro
    • 1
    • 2
  • Zohar Keidar
    • 3
  • Charito Love
    • 1
  1. 1.Albert Einstein College of Medicine of Yeshiva UniversityBronxUSA
  2. 2.Division of Nuclear Medicine and Molecular ImagingNorth Shore Long Island Jewish Health SystemBronxUSA
  3. 3.Division of Nuclear MedicineB. and R. Rappaport School of Medicine, Rambam Health Care CampusHaifaIsrael

Personalised recommendations