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A pilot study to evaluate the role of 18F-FDG labeled WBC PET/CT in infection imaging in patients with diabetic foot and osteomyelitis at St. Luke's Medical Center.

Author

Jamilla Cecilia  L. Gomez,
Allan Jay  C. Domingo,
Althea Camilla D. Robin,
Jonas Francisco Y. Santiago

Related Institution

Department of Nuclear Medicine and PET Center - St. Luke's Medical Center

Publication Information

Publication Type
Journal
Title
St. Luke
Frequency
Quarterly
Publication Date
January-March 2014
Volume
9
Issue
1
Page(s)
55-62

Abstract

Introduction. Infectious cases require prompt diagnosis for effective therapy. Imaging infection in nuclear medicine uses radiotracers with different mechanisms of actions.


Objectives. The objective of this study was to determine the potential role of 18F-fluorodeoxyglucose labeled leukocytes (FDG-WBC) positron emission tomography with low-dose CT (PET-CT) in infection imaging in patients with diabetic foot and osteomyelitis at St. Luke's Medical Center.


Methodology. There were 11 participants (6 male, 5 female; mean age of 49±18.6 years) with diabetic foot or suspected with osteomyelitis from November 2009-October 2012. In vitro labeling of autologous human leukocytes with 18F-FDG was done. Labeling efficiency and cell viability values were obtained. A PET-CT of the infection site was performed 65.1±8.4 minutes after injection of 96.4±42.5 MBq of FDG-WBC. The scans were read as positive or negative for infection by 3 Nuclear Medicine physicians and subsequently compared to a reference standard (histopathology or clinical end-diagnosis).


Results. Radiochemical purity, cell viability and labeling effiency were >95%, 98.6±1%, and 17.4±6%, respectively. No adverse reactions were encountered. There were 10 positive PET-CT results. Nine had concordant final diagnosis of infection. The one false positive PET result had a final diagnosis of Giant cell tumor. One patient had a negative PET-CT finding but was diagnosed to have infection. There were 9 concordant and 2 discordant results. 


Conclusion. FDG-WBC PET-CT scan is useful in imaging patients with diabetic foot and osteomyelitis. It has shorter radiotracer half-life, waiting time post-injection, scan duration and superior images than other infection scans.


 

References

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