Ces radiol. 2012, 66(4):403-409

A role of hybrid imaging methods in the detection of occult pyogenous musculoskeletal inflammations in patients in septic stateOriginal article

Jiří Ferda¹, Eva Ferdova¹, Alexander Malán¹, Jan Záhlava¹, Jan Baxa¹, Martin Matějovič², Boris Kreuzberg¹

¹ Klinika zobrazovacích metod LF UK a FN, Plzeň

² 1. interní klinika LF UK a FN, Plzeň

Aim: To asses a role and frequency of indications of hybrid imaging methods in the detection of occult pyogenous musculoskeletal inflammation as a cause of the septic state of unknown origin.

Method: The retrospective evaluation of the hybrid imaging indicated due a sepsis of unknown origin during three years was performed. All procedures of ¹⁸F-FDG-PET/CT and the SPECT/CT using labeled leucocytes were enrolled into the assessment.

Results: 27 procedures of ¹⁸F-FDG-PET/CT were performed due to the searching of the cause in cases of the sepsis of unknown origin; the spondylodiscitis was found in 6 cases, pyogenous arthritis in 3 cases, muscular abscesses in 2 cases and 4 cases of pyogenous infection of implanted joint prosthesis. Muskuloskeletal inflammations formed 55,5% of all findings.
16 procedures of SPECT/CT were performed, 10 using ^99mTc-labeled antigranulocyte antibodies, and 6 using ^99mTc-HMPAO labeled leukocytes. In 2 cases, the acute spondylodiscitis was found, one case of chronic spondylitis and one case of soft tissue abscesses due to the infection of endoprosthesis were found. Muskuloskeletal inflammations formed 25% of all findings.

Conclusion: During the period of the parallel use of PET/CT and SPECT/CT in detection of occult infection, the majority of procedures were performed using ¹⁸F-FDG-PET/CT, offering multiple advantages over leukocyte imaging.

Keywords: sepsis, PET/CT, SPECT/CT, labeled leucocytes, antileukocytic antibody

Grants and funding:

Práce byla podpořena Programem rozvoje Univerzity Karlovy (projekt číslo P36).

Accepted: September 15, 2012; Published: December 1, 2012  Show citation