CHRONIC OSTEOMYELITIS - DETECTION WITH FDG PET AND CORRELATION WITH HISTOPATHOLOGIC FINDINGS

PURPOSE: To evaluate use of positron emission tomography (PET) with 2- (fluorine-18) fluoro-2-deoxy-D-glucose (FDG) in detection of chronic o steomyelitis. MATERIALS AND METHODS: Thirty-one patients suspected to have chronic osteomyelitis in the peripheral (n = 21) or central (n = 10) skeleton were evaluated prospectively with FDG PET. Analysis of th e receiver operating characteristic curve was performed. The final dia gnosis was made by means of bacteriologic culture of surgical specimen s and histopathologic analysis. RESULTS: FDG PET allowed identificatio n of 17 of 18 patients with osteomyelitis and 12 of 13 without osteomy elitis. There was one false-positive and one equivocal result. The are a under the ROC curve was 0.96 for all patients, 1.00 for patients sus pected to have osteomyelitis in the peripheral skeleton. The overall a ccuracy of FDG PET was 97% with a high degree of interobserver concord ance (kappa = 0.93). The overall sensitivity and specificity were 100% and 92%, respectively. CONCLUSION: FDG PET enables noninvasive detect ion and demonstration of the extent of chronic osteomyelitis with a hi gh degree of accuracy. Especially in the central skeleton within activ e bone marrow, FDG PET is highly accurate and shows great promise in d iagnosis of chronic osteomyelitis.