Skip to main content
Top
Published in: European Journal of Nuclear Medicine and Molecular Imaging 11/2005

01-11-2005 | Original Article

Comparison of 18F-FDG and 68Ga PET imaging in the assessment of experimental osteomyelitis due to Staphylococcus aureus

Authors: Tatu J. Mäkinen, Petteri Lankinen, Tiina Pöyhönen, Jari Jalava, Hannu T. Aro, Anne Roivainen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2005

Login to get access

Abstract

Purpose

Although positron emission tomography (PET) using 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) is a promising imaging modality for bone infections, the technique may still give false-positive results due to unspecific uptake in healing bone. This experimental study compared 18F-FDG and 68Ga in PET imaging of osteomyelitis and normal bone healing.

Methods

A diffuse osteomyelitis model of the tibia was applied in the rat (n=50). Two weeks after operation, PET imaging with 18F-FDG and 68Ga was performed, followed by peripheral quantitative computed tomography (pQCT) and radiography. Osteomyelitis was verified by quantitative bacteriology. In addition to in vivo imaging, ex vivo measurements of tissue radioactivity were performed to verify uptake of the tracers.

Results

Compared with controls with normal bone healing, the osteomyelitic tibias showed increased SUV ratios (i.e. radioactivity ratios between the operated and non-operated sides) for both 18F-FDG (1.74±0.37) and 68Ga (1.62±0.28) (P<0.001). Ex vivo measurements also showed increased tracer accumulation in the infected bone (P=0.003 for 18F-FDG and P<0.001 for 68Ga). The intensity of 68Ga uptake reflected pathological changes of osteomyelitic bones measured by pQCT. The uptake of 18F-FDG, however, did not show as close a correlation with the anatomical changes. The healing bones without infection exhibited slightly elevated uptake of 18F-FDG (SUV ratio 1.16±0.06), but 68Ga did not accumulate in the healing bone, as judged on the basis of both in vivo imaging (SUV ratio 1.02±0.05) and ex vivo measurements (SUV 0.92±0.21) (P=0.003 and P=0.022 compared with 18F-FDG uptake, respectively).

Conclusion

This study suggests the feasibility of 68Ga PET imaging of bone infections. However, further studies are needed to clarify the value of 68Ga PET for clinical purposes.
Literature
1.
go back to reference Guhlmann A, Brecht-Krauss D, Suger G, Glatting G, Kotzerke J, Kinzl L, et al. Fluorine-18-FDG PET and technetium-99m antigranulocyte antibody scintigraphy in chronic osteomyelitis. J Nucl Med 1998;39:2145–52PubMed Guhlmann A, Brecht-Krauss D, Suger G, Glatting G, Kotzerke J, Kinzl L, et al. Fluorine-18-FDG PET and technetium-99m antigranulocyte antibody scintigraphy in chronic osteomyelitis. J Nucl Med 1998;39:2145–52PubMed
2.
go back to reference Kälicke T, Schmitz A, Risse JH, Arens S, Keller E, Hansis M, et al. Fluorine-18 fluorodeoxyglucose PET in infectious bone diseases: results of histologically confirmed cases. Eur J Nucl Med 2000;27:524–8PubMedCrossRef Kälicke T, Schmitz A, Risse JH, Arens S, Keller E, Hansis M, et al. Fluorine-18 fluorodeoxyglucose PET in infectious bone diseases: results of histologically confirmed cases. Eur J Nucl Med 2000;27:524–8PubMedCrossRef
3.
go back to reference de Winter F, van de Wiele C, Vogelaers D, de Smet K, Verdonk B, Dierckx RA. Fluorine-18 fluorodeoxyglucose-positron emission tomography: a highly accurate imaging modality for the diagnosis of chronic musculoskeletal infections. J Bone Joint Surg 2001;83A:651–60 de Winter F, van de Wiele C, Vogelaers D, de Smet K, Verdonk B, Dierckx RA. Fluorine-18 fluorodeoxyglucose-positron emission tomography: a highly accurate imaging modality for the diagnosis of chronic musculoskeletal infections. J Bone Joint Surg 2001;83A:651–60
4.
go back to reference Stumpe KD, Dazzi H, Schaffner A, von Schulthess GK. Infection imaging using whole-body FDG-PET. Eur J Nucl Med 2000;27:822–32PubMedCrossRef Stumpe KD, Dazzi H, Schaffner A, von Schulthess GK. Infection imaging using whole-body FDG-PET. Eur J Nucl Med 2000;27:822–32PubMedCrossRef
5.
go back to reference Ichiya Y, Kuwabara Y, Sasaki M, Yoshida T, Akashi Y, Murayama S, et al. FDG-PET in infectious lesions: the detection and assessment of lesion activity. Ann Nucl Med 1996;10:185–91PubMedCrossRef Ichiya Y, Kuwabara Y, Sasaki M, Yoshida T, Akashi Y, Murayama S, et al. FDG-PET in infectious lesions: the detection and assessment of lesion activity. Ann Nucl Med 1996;10:185–91PubMedCrossRef
6.
go back to reference Sugawara Y, Gutowski TD, Fisher SJ, Brown RS, Wahl RL. Uptake of positron emission tomography tracers in experimental bacterial infections: a comparative biodistribution study of radiolabeled FDG, thymidine, L-methionine, 67Ga-citrate, and 125I-HSA. Eur J Nucl Med 1999;26:333–41PubMedCrossRef Sugawara Y, Gutowski TD, Fisher SJ, Brown RS, Wahl RL. Uptake of positron emission tomography tracers in experimental bacterial infections: a comparative biodistribution study of radiolabeled FDG, thymidine, L-methionine, 67Ga-citrate, and 125I-HSA. Eur J Nucl Med 1999;26:333–41PubMedCrossRef
7.
go back to reference Einhorn TA. The cell and molecular biology of fracture healing. Clin Orthop 1998;355S:7–21CrossRef Einhorn TA. The cell and molecular biology of fracture healing. Clin Orthop 1998;355S:7–21CrossRef
8.
go back to reference de Winter F, Vogelaers D, Gemmel F, Dierckx RA. Promising role of 18-F-fluoro-D-deoxyglucose positron emission tomography in clinical infectious diseases. Eur J Clin Microbiol Infect Dis 2002;21:247–57PubMedCrossRef de Winter F, Vogelaers D, Gemmel F, Dierckx RA. Promising role of 18-F-fluoro-D-deoxyglucose positron emission tomography in clinical infectious diseases. Eur J Clin Microbiol Infect Dis 2002;21:247–57PubMedCrossRef
9.
go back to reference Koort JK, Mäkinen TJ, Knuuti J, Jalava J, Aro HT. Comparative 18F-FDG-PET imaging of experimental Staphylococcus aureus osteomyelitis and normal bone healing. J Nucl Med 2004;45:1406–11PubMed Koort JK, Mäkinen TJ, Knuuti J, Jalava J, Aro HT. Comparative 18F-FDG-PET imaging of experimental Staphylococcus aureus osteomyelitis and normal bone healing. J Nucl Med 2004;45:1406–11PubMed
10.
11.
go back to reference Chianelli M, Mather SJ, Martin-Comin J, Signore A. Radiopharmaceuticals for the study of inflammatory processes: a review. Nucl Med Commun 1997;18:437–55PubMedCrossRef Chianelli M, Mather SJ, Martin-Comin J, Signore A. Radiopharmaceuticals for the study of inflammatory processes: a review. Nucl Med Commun 1997;18:437–55PubMedCrossRef
12.
go back to reference Peters AM. The utility of 99mTc HMPAO-leukocytes for imaging infection. Semin Nucl Med 1994;24:110–27PubMedCrossRef Peters AM. The utility of 99mTc HMPAO-leukocytes for imaging infection. Semin Nucl Med 1994;24:110–27PubMedCrossRef
13.
go back to reference Datz FL. Abdominal abscess detection: gallium, 111In-, and 99mTc-labeled leukocytes, and polyclonal and monoclonal antibodies. Semin Nucl Med 1996;26:51–64PubMedCrossRef Datz FL. Abdominal abscess detection: gallium, 111In-, and 99mTc-labeled leukocytes, and polyclonal and monoclonal antibodies. Semin Nucl Med 1996;26:51–64PubMedCrossRef
14.
go back to reference Alazraki NP. Gallium-67 imaging in infection. In: Early PJ, Sodee DB, editors. Principles and practice of nuclear medicine, 2nd ed. St. Louis: Mosby-Year Book; 1995. p. 702–13 Alazraki NP. Gallium-67 imaging in infection. In: Early PJ, Sodee DB, editors. Principles and practice of nuclear medicine, 2nd ed. St. Louis: Mosby-Year Book; 1995. p. 702–13
15.
go back to reference Roivainen A, Tolvanen T, Salomäki S, Lendvai G, Velikyan I, Numminen P, et al. 68Ga-labeled oligonucleotides for in vivo imaging with PET. J Nucl Med 2004;45:347–55PubMed Roivainen A, Tolvanen T, Salomäki S, Lendvai G, Velikyan I, Numminen P, et al. 68Ga-labeled oligonucleotides for in vivo imaging with PET. J Nucl Med 2004;45:347–55PubMed
16.
go back to reference Rissing JP. Animal models of osteomyelitis. Knowledge, hypothesis, and speculation. Infect Dis Clin North Am 1990;4:377–90PubMed Rissing JP. Animal models of osteomyelitis. Knowledge, hypothesis, and speculation. Infect Dis Clin North Am 1990;4:377–90PubMed
18.
go back to reference O’Reilly T, Mader JT. Rat model of bacterial osteomyelitis of the tibia. In: Zak O, Sande MA, editors. Handbook of animal models of infection. Bath, Avon, UK: Academic; 1999. p. 561–75CrossRef O’Reilly T, Mader JT. Rat model of bacterial osteomyelitis of the tibia. In: Zak O, Sande MA, editors. Handbook of animal models of infection. Bath, Avon, UK: Academic; 1999. p. 561–75CrossRef
19.
go back to reference Nelson DR, Buxton TB, Luu QN, Rissing JP. The promotional effect of bone wax on experimental Staphylococcus aureus osteomyelitis. J Thorac Cardiovasc Surg 1990;99:977–80PubMed Nelson DR, Buxton TB, Luu QN, Rissing JP. The promotional effect of bone wax on experimental Staphylococcus aureus osteomyelitis. J Thorac Cardiovasc Surg 1990;99:977–80PubMed
20.
go back to reference Hamacher K, Coenen HH, Stocklin G. Efficient stereospecific synthesis of no-carrier-added 2-[18F]-fluoro-2-deoxy-D-glucose using aminopolyether supported nucleophilic substitution. J Nucl Med 1986;27:235–8PubMed Hamacher K, Coenen HH, Stocklin G. Efficient stereospecific synthesis of no-carrier-added 2-[18F]-fluoro-2-deoxy-D-glucose using aminopolyether supported nucleophilic substitution. J Nucl Med 1986;27:235–8PubMed
21.
go back to reference DeGrado TR, Turkington TG, Williams JJ, Stearns CW, Hoffman JM, Coleman RE. Performance characteristics of a whole-body PET scanner. J Nucl Med 1994;35:1398–1406PubMed DeGrado TR, Turkington TG, Williams JJ, Stearns CW, Hoffman JM, Coleman RE. Performance characteristics of a whole-body PET scanner. J Nucl Med 1994;35:1398–1406PubMed
22.
go back to reference Rissing JP, Buxton TB, Weinstein RS, Shockley RK. Model of experimental chronic osteomyelitis in rats. Infect Immun 1985;47:581–6PubMedCentralPubMed Rissing JP, Buxton TB, Weinstein RS, Shockley RK. Model of experimental chronic osteomyelitis in rats. Infect Immun 1985;47:581–6PubMedCentralPubMed
23.
go back to reference van Griethuysen A, Bes M, Etienne J, Zbinden R, Kluytmans J. International multicenter evaluation of latex agglutination tests for identification of Staphylococcus aureus. J Clin Microbiol 2001;39:86–9PubMedCentralPubMedCrossRef van Griethuysen A, Bes M, Etienne J, Zbinden R, Kluytmans J. International multicenter evaluation of latex agglutination tests for identification of Staphylococcus aureus. J Clin Microbiol 2001;39:86–9PubMedCentralPubMedCrossRef
24.
go back to reference Petty W, Spanier S, Shuster JJ, Silverthorne C. The influence of skeletal implants on incidence of infection. Experiments in a canine model. J Bone Joint Surg 1985;67A:1236–44 Petty W, Spanier S, Shuster JJ, Silverthorne C. The influence of skeletal implants on incidence of infection. Experiments in a canine model. J Bone Joint Surg 1985;67A:1236–44
25.
go back to reference Hnatowich DJ. A review of radiopharmaceutical development with short-lived generator-produced radionuclides other than 99mTc. Int J Appl Radiat Isot 1977;28:169–81PubMedCrossRef Hnatowich DJ. A review of radiopharmaceutical development with short-lived generator-produced radionuclides other than 99mTc. Int J Appl Radiat Isot 1977;28:169–81PubMedCrossRef
26.
go back to reference Oyen WJ, Boerman OC, van der Laken CJ, Claessens RA, van der Meer JW, Corstens FH. The uptake mechanisms of inflammation- and infection-localizing agents. Eur J Nucl Med 1996;23:459–65PubMedCrossRef Oyen WJ, Boerman OC, van der Laken CJ, Claessens RA, van der Meer JW, Corstens FH. The uptake mechanisms of inflammation- and infection-localizing agents. Eur J Nucl Med 1996;23:459–65PubMedCrossRef
27.
go back to reference Green MA, Welch MJ. Gallium radiopharmaceutical chemistry. Int J Rad Appl Instrum B 1989;16:435–48PubMedCrossRef Green MA, Welch MJ. Gallium radiopharmaceutical chemistry. Int J Rad Appl Instrum B 1989;16:435–48PubMedCrossRef
28.
go back to reference Hoffman EJ, Huang SC, Phelps ME. Quantitation in positron emission computed tomography: 1. Effect of object size. J Comput Assist Tomogr 1979;3:299–308PubMedCrossRef Hoffman EJ, Huang SC, Phelps ME. Quantitation in positron emission computed tomography: 1. Effect of object size. J Comput Assist Tomogr 1979;3:299–308PubMedCrossRef
29.
go back to reference Boellaard R, Krak NC, Hoekstra OS, Lammertsma AA. Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: a simulation study. J Nucl Med 2004;45:1519–27PubMed Boellaard R, Krak NC, Hoekstra OS, Lammertsma AA. Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: a simulation study. J Nucl Med 2004;45:1519–27PubMed
30.
go back to reference Visvikis D, Cheze-LeRest C, Costa DC, Bomanji J, Gacinovic S, Ell PJ. Influence of OSEM and segmented attenuation correction in the calculation of standardised uptake values for [18F]FDG PET. Eur J Nucl Med 2001;28:1326–35PubMedCrossRef Visvikis D, Cheze-LeRest C, Costa DC, Bomanji J, Gacinovic S, Ell PJ. Influence of OSEM and segmented attenuation correction in the calculation of standardised uptake values for [18F]FDG PET. Eur J Nucl Med 2001;28:1326–35PubMedCrossRef
31.
go back to reference Boellaard R, van Lingen A, Lammertsma AA. Experimental and clinical evaluation of iterative reconstruction (OSEM) in dynamic PET: quantitative characteristics and effects on kinetic modeling. J Nucl Med 2001;42:808–17PubMed Boellaard R, van Lingen A, Lammertsma AA. Experimental and clinical evaluation of iterative reconstruction (OSEM) in dynamic PET: quantitative characteristics and effects on kinetic modeling. J Nucl Med 2001;42:808–17PubMed
32.
go back to reference Gratz S, Béhé M, Boerman OC, Kunze E, Schulz H, Eiffert H, et al. 99mTc-E-selectin binding peptide for imaging acute osteomyelitis in a novel rat model. Nucl Med Commun 2001;22:1003–13PubMedCrossRef Gratz S, Béhé M, Boerman OC, Kunze E, Schulz H, Eiffert H, et al. 99mTc-E-selectin binding peptide for imaging acute osteomyelitis in a novel rat model. Nucl Med Commun 2001;22:1003–13PubMedCrossRef
33.
go back to reference Sammak B, Abd El Bagi M, Al Shahed M, Hamilton D, Al Nabulsi J, Youssef B, et al. Osteomyelitis: a review of currently used imaging techniques. Eur Radiol 1999;9:894–900PubMedCrossRef Sammak B, Abd El Bagi M, Al Shahed M, Hamilton D, Al Nabulsi J, Youssef B, et al. Osteomyelitis: a review of currently used imaging techniques. Eur Radiol 1999;9:894–900PubMedCrossRef
34.
go back to reference Govender S, Csimma C, Genant HK, Valentin-Opran A, Amit Y, Arbel R, et al. Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients. J Bone Joint Surg 2002;84A:2123–34 Govender S, Csimma C, Genant HK, Valentin-Opran A, Amit Y, Arbel R, et al. Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients. J Bone Joint Surg 2002;84A:2123–34
Metadata
Title
Comparison of 18F-FDG and 68Ga PET imaging in the assessment of experimental osteomyelitis due to Staphylococcus aureus
Authors
Tatu J. Mäkinen
Petteri Lankinen
Tiina Pöyhönen
Jari Jalava
Hannu T. Aro
Anne Roivainen
Publication date
01-11-2005
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2005
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-005-1841-9

Other articles of this Issue 11/2005

European Journal of Nuclear Medicine and Molecular Imaging 11/2005 Go to the issue

Announcements

November 2005