Secondary Logo

Journal Logo

They performed a prospective observational diagnostic accuracy study in 33 participants with fever or suspected periprosthetic infection and increased C-reactive protein and elevated leukocyte count. All participants underwent 18F-WBC PET/CT scan and 18F-FDG PET/CT on 2 different days. Images were evaluated by visual analyses of uptake intensity and SUVmax.

For both 18F-FDG and 18F-WBC PET/CT, the lesion-to-background ratio of <1.5 was recorded as grade 0, 1.5–2.5 as grade 1a, 2.5–3.5 as grade 1b, 3.5–4.5 as grade 2, and >4.5 as grade 3.

Final diagnosis was made by histopathological, microbiological analysis, or clinical-radiological workup. Twenty-nine foci of suspected infection were found in 25/33 patients by either 18F-FDG PET/CT or 18F-WBC PET/CT scan. Eight patients had no abnormal uptake on either exam.

There was a concordance of 18F-FDG PET/CT and 18F-WBC PET/CT in 28 of 29 sites each using grade 1b of visual and quantitative analysis, respectively. Of 29 suspicious infected foci, 18 were proven positive for infection (14/18 sites by the histopathological/microbiological culture and the rest 4/18 sites by clinical/radiological workup). Culture of aspirates or biopsy from 11/29 suspicious sites was proven noninfective. Seven of 11 suspicious sites were proven noninfective. The mean clinical follow-up was 8 months (1–15 months).

Significantly higher diagnostic accuracy was demonstrated with 18F-WBC PET/CT (89%) in comparison to 18F-FDG PET/CT (73%) for the detection of infection ( P < 0.05). The highest diagnostic accuracy of 18F-WBC PET/CT scan was reported with both grade 1b of visual as well as of quantitative analysis (lesion-to-background SUVmax, 2.5–3.5) and grade 2 for both visual and quantitative analysis for 18F FDG PET/CT.

The authors concluded that 18F-WBC PET/CT has a higher diagnostic accuracy over 18F-FDG PET/CT for the diagnosis of occult infection.​

Current Issue

Evaluation of the Hybrid Tracer Indocyanine Green–99mTc-Nanocolloid for Sentinel Node Biopsy in Bladder Cancer—A Prospective Pilot Study

Rietbergen, Daphne D.D.; van Gennep, Erik J.; KleinJan, Gijs H.; More

Clinical Nuclear Medicine. 47(9):774-780, September 2022.

Delayed [18F]-FDG PET Imaging Increases Diagnostic Performance and Reproducibility to Differentiate Recurrence of Brain Metastases From Radionecrosis

Otman, Hosameldin; Farce, Julien; Meneret, Pierre; More

Clinical Nuclear Medicine. 47(9):800-806, September 2022.