Nucl Med Mol Imaging.  2019 Aug;53(4):253-262. 10.1007/s13139-019-00599-6.

Utility of FDG-PET/CT for the Detection and Characterization of Sternal Wound Infection Following Sternotomy

Affiliations
  • 1Department of Medical Imaging, Institut de cardiologie de Montréal, Montreal, Quebec, Canada. hadi.hariri@umontreal.ca, Steph_tan@hotmail.com, vincent.finnerty@icm-mhi.org, sebastien.authier@icm-mhi.org, francois_harel@hotmail.com, matthieu.pelletier-galarneau@icm-mhi.org
  • 2Department of Radiology, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada. pjmartineau@gmail.com
  • 3Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • 4Department of Surgery, Institut de cardiologie de Montréal, Montreal, Quebec, Canada. yoanlamarche@gmail.com, michel.carrier@icm-mhi.org

Abstract

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, SUV(max), 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.
CONCLUSION
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. SUV(max) 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.

Keyword

FDG-PET; Sternal wound infection; Infection imaging; Sternotomy

MeSH Terms

Area Under Curve
Consensus
Diagnosis
Humans
Retrospective Studies
Sensitivity and Specificity
Sternotomy*
Wound Infection*
Wounds and Injuries*
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