18-Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography scan for monitoring the therapeutic response in experimental Staphylococcus aureus foreign-body osteomyelitis

Sofia Chatziioannou, Odysseas Papamichos, Maria N. Gamaletsou, Alexandros Georgakopoulos, Nikolaos G. Kostomitsopoulos, Sofia Tseleni-Balafouta, Joseph Papaparaskevas, Thomas J. Walsh, Spiros G. Pneumaticos, Nikolaos V. Sipsas

Research output: Contribution to journalArticle

Abstract

Background: 18-Fluoro-2-deoxy-d-glucose positron emission tomography combined with computed tomography (18F-FDG PET/CT) scan is useful for diagnosis of osteoarticular infections. Whether 18F-FDG PET/CT scanning may be used for therapeutic monitoring is not clear. The objective of this study was to develop 18F-FDG PET/CT scanning for monitoring therapeutic response to antimicrobials in experimental Staphylococcus aureus osteomyelitis. Methods: A total of 22 rabbits were studied. In 20 animals, the right tibia was inoculated intraoperatively with S. aureus. Two control animals were inoculated with normal saline. A needle was placed in the tibia as a foreign body. Infection was allowed to develop for 21 days when 18F-FDG PET/CT was performed, the needle was removed, and bone specimens were cultured to confirm infection. Antimicrobial therapy with daptomycin was initiated in all successfully infected animals for 1, 3, or 6 weeks. Following completion of treatment, a second 18F-FDG PET/CT was performed, animals were euthanized, and infected tibias were harvested for quantitative cultures and histology. A positive scan was defined as 18F-FDG signal activity greater in the infected tibia than that of the contralateral non-infected control tibia. Therapeutic response was measured by the change of 18F-FDG signal activity in the infected tibia. Results: All successfully infected animals (n=14), with microbiologically and/or histologically confirmed osteomyelitis, had positive 18F-FDG PET/CT scans, while the two control animals had negative scans despite the presence of the foreign body [mean maximum standardized uptake value (SUVmax) (±SD) values 2.96 (±0.80) vs. 1 (±1.10), respectively, P=0.04]. In the 14 successfully infected animals, the mean SUVmax was significantly higher in the infected compared to the uninfected tibia (P18F-FDG PET/CT scan (n=4), while animals with persistent infection despite treatment (n=12) had a positive 18F-FDG PET/CT scan (SUVmax 1.0-3.0) (p18F-FDG PET/CT scan is a sensitive and specific tool in therapeutic monitoring of experimental foreign-body osteomyelitis.

Original languageEnglish (US)
Article number132
JournalJournal of Orthopaedic Surgery and Research
Volume10
Issue number1
DOIs
StatePublished - Aug 27 2015
Externally publishedYes

Fingerprint

Fluorodeoxyglucose F18
Osteomyelitis
Foreign Bodies
Staphylococcus aureus
Tibia
Glucose
Therapeutics
Infection
Needles
Animal Rights
Daptomycin
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography
Histology
Tomography
Rabbits
Bone and Bones

Keywords

  • <sup>18</sup>F-FDG PET/CT
  • Daptomycin
  • Experimental osteomyelitis
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

18-Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography scan for monitoring the therapeutic response in experimental Staphylococcus aureus foreign-body osteomyelitis. / Chatziioannou, Sofia; Papamichos, Odysseas; Gamaletsou, Maria N.; Georgakopoulos, Alexandros; Kostomitsopoulos, Nikolaos G.; Tseleni-Balafouta, Sofia; Papaparaskevas, Joseph; Walsh, Thomas J.; Pneumaticos, Spiros G.; Sipsas, Nikolaos V.

In: Journal of Orthopaedic Surgery and Research, Vol. 10, No. 1, 132, 27.08.2015.

Research output: Contribution to journalArticle

Chatziioannou, S, Papamichos, O, Gamaletsou, MN, Georgakopoulos, A, Kostomitsopoulos, NG, Tseleni-Balafouta, S, Papaparaskevas, J, Walsh, TJ, Pneumaticos, SG & Sipsas, NV 2015, '18-Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography scan for monitoring the therapeutic response in experimental Staphylococcus aureus foreign-body osteomyelitis', Journal of Orthopaedic Surgery and Research, vol. 10, no. 1, 132. https://doi.org/10.1186/s13018-015-0274-9
Chatziioannou, Sofia ; Papamichos, Odysseas ; Gamaletsou, Maria N. ; Georgakopoulos, Alexandros ; Kostomitsopoulos, Nikolaos G. ; Tseleni-Balafouta, Sofia ; Papaparaskevas, Joseph ; Walsh, Thomas J. ; Pneumaticos, Spiros G. ; Sipsas, Nikolaos V. / 18-Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography scan for monitoring the therapeutic response in experimental Staphylococcus aureus foreign-body osteomyelitis. In: Journal of Orthopaedic Surgery and Research. 2015 ; Vol. 10, No. 1.
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abstract = "Background: 18-Fluoro-2-deoxy-d-glucose positron emission tomography combined with computed tomography (18F-FDG PET/CT) scan is useful for diagnosis of osteoarticular infections. Whether 18F-FDG PET/CT scanning may be used for therapeutic monitoring is not clear. The objective of this study was to develop 18F-FDG PET/CT scanning for monitoring therapeutic response to antimicrobials in experimental Staphylococcus aureus osteomyelitis. Methods: A total of 22 rabbits were studied. In 20 animals, the right tibia was inoculated intraoperatively with S. aureus. Two control animals were inoculated with normal saline. A needle was placed in the tibia as a foreign body. Infection was allowed to develop for 21 days when 18F-FDG PET/CT was performed, the needle was removed, and bone specimens were cultured to confirm infection. Antimicrobial therapy with daptomycin was initiated in all successfully infected animals for 1, 3, or 6 weeks. Following completion of treatment, a second 18F-FDG PET/CT was performed, animals were euthanized, and infected tibias were harvested for quantitative cultures and histology. A positive scan was defined as 18F-FDG signal activity greater in the infected tibia than that of the contralateral non-infected control tibia. Therapeutic response was measured by the change of 18F-FDG signal activity in the infected tibia. Results: All successfully infected animals (n=14), with microbiologically and/or histologically confirmed osteomyelitis, had positive 18F-FDG PET/CT scans, while the two control animals had negative scans despite the presence of the foreign body [mean maximum standardized uptake value (SUVmax) (±SD) values 2.96 (±0.80) vs. 1 (±1.10), respectively, P=0.04]. In the 14 successfully infected animals, the mean SUVmax was significantly higher in the infected compared to the uninfected tibia (P18F-FDG PET/CT scan (n=4), while animals with persistent infection despite treatment (n=12) had a positive 18F-FDG PET/CT scan (SUVmax 1.0-3.0) (p18F-FDG PET/CT scan is a sensitive and specific tool in therapeutic monitoring of experimental foreign-body osteomyelitis.",
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AU - Papamichos, Odysseas

AU - Gamaletsou, Maria N.

AU - Georgakopoulos, Alexandros

AU - Kostomitsopoulos, Nikolaos G.

AU - Tseleni-Balafouta, Sofia

AU - Papaparaskevas, Joseph

AU - Walsh, Thomas J.

AU - Pneumaticos, Spiros G.

AU - Sipsas, Nikolaos V.

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N2 - Background: 18-Fluoro-2-deoxy-d-glucose positron emission tomography combined with computed tomography (18F-FDG PET/CT) scan is useful for diagnosis of osteoarticular infections. Whether 18F-FDG PET/CT scanning may be used for therapeutic monitoring is not clear. The objective of this study was to develop 18F-FDG PET/CT scanning for monitoring therapeutic response to antimicrobials in experimental Staphylococcus aureus osteomyelitis. Methods: A total of 22 rabbits were studied. In 20 animals, the right tibia was inoculated intraoperatively with S. aureus. Two control animals were inoculated with normal saline. A needle was placed in the tibia as a foreign body. Infection was allowed to develop for 21 days when 18F-FDG PET/CT was performed, the needle was removed, and bone specimens were cultured to confirm infection. Antimicrobial therapy with daptomycin was initiated in all successfully infected animals for 1, 3, or 6 weeks. Following completion of treatment, a second 18F-FDG PET/CT was performed, animals were euthanized, and infected tibias were harvested for quantitative cultures and histology. A positive scan was defined as 18F-FDG signal activity greater in the infected tibia than that of the contralateral non-infected control tibia. Therapeutic response was measured by the change of 18F-FDG signal activity in the infected tibia. Results: All successfully infected animals (n=14), with microbiologically and/or histologically confirmed osteomyelitis, had positive 18F-FDG PET/CT scans, while the two control animals had negative scans despite the presence of the foreign body [mean maximum standardized uptake value (SUVmax) (±SD) values 2.96 (±0.80) vs. 1 (±1.10), respectively, P=0.04]. In the 14 successfully infected animals, the mean SUVmax was significantly higher in the infected compared to the uninfected tibia (P18F-FDG PET/CT scan (n=4), while animals with persistent infection despite treatment (n=12) had a positive 18F-FDG PET/CT scan (SUVmax 1.0-3.0) (p18F-FDG PET/CT scan is a sensitive and specific tool in therapeutic monitoring of experimental foreign-body osteomyelitis.

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