Coincidence camera FDG imaging for the diagnosis of chronic orthopedic infections: A feasibility study

Purpose: Results of dedicated [F-18]fluoro-2-deoxy-D-glucose (FDG) PET imag ing in patients with suspected orthopedic infections are promising. This st udy evaluates the feasibility of dual-head gamma-camera coincidence (DHC) i maging in this population. Method: Twenty-four patients, referred for the confirmation or exclusion of orthopedic infection, were prospectively studied with consecutive FDG-dedi cated PET and FDG DHC imaging. Images were read by two blinded readers expe rienced with FDG PET and compared with the final diagnosis, obtained by mic robiologic proof in 11 patients and clinical follow-up of at least 9 months in 13 patients. Results: Nine patients had osseous infection on final diagnosis. Sensitivit y, specificity, and accuracy in this limited series were (Reader 1/Reader 2 ), respectively, 100/100, 86/86, and 92/92% for FDG-dedicated PET and 89/89 , 100/93, and 96/92% for FDG DHC imaging. Conclusion: Despite lower image quality for FDG DHC imaging, results in thi s limited series were comparable with the results of FDG-dedicated PET. Fur ther studies are needed to confirm the utility of FDG DHC imaging in suspec ted chronic orthopedic infections in larger patient groups.