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KMID : 1148920190530040253
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Nuclear Medicine and Molecular Imaging
2019 Volume.53 No. 4 p.253 ~ p.262
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Utility of FDG-PET/CT for the Detection and Characterization of Sternal Wound Infection Following Sternotomy
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Hariri Hadi
Tan Stephanie
Martineau Patrick
Lamarche Yoan
Carrier Michel
Finnerty Vincent
Authier Sebastien
Harel Francois
Pelletier-Galarneau Matthieu
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Abstract
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Purpose: FDG-PET/CT has the potential to play an important role in the diagnosis of sternal wound infections (SWI). The purpose of this study was to analyze the diagnostic accuracy of FDG-PET/CT for SWI in patients following sternotomy.
Methods: We performed a single-center, retrospective analysis of patients who had undergone median sternotomy and FDG-PET/CT imaging. The gold standard consisted of positive bacterial culture and/or the presence of purulent material at surgery. Qualitative patterns of sternal FDG uptake, SUVmax, and associated CT findings were determined, and an imaging scoring system was developed. The diagnostic performances were studied in both the recent (≤?6 months between sternotomy and imaging) and remote surgery phase (>?6 months).
Results: A total of 40 subjects were identified with 11 confirmed SWI cases. Consensus interpretation was associated with a sensitivity of 91% and specificity of 97%. Combination of uptake patterns yielded an AUC of 0.96 while use of SUVmax yielded an AUC of 0.82.
Conclusions: Results suggest that FDG-PET/CT may be useful for the diagnosis of SWI with optimal diagnostic accuracy achieved by identifying specific patterns of uptake. SUVmax can be helpful in assessing subjects with remote surgery, but its use is limited in the context of recent surgery. Further studies are required to confirm these results.
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KEYWORD
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FDG-PET, Sternal wound infection, Infection imaging, Sternotomy
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