Tatiana Segard1, Laurence M J A Morandeau2, Marina L Dunne1,3, James O Robinson4,5, Ronan J Murray6, Elizabeth A Geelhoed7, Roslyn J Francis1,8. 1. Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. 2. Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. 3. Department of Nuclear Medicine, Royal Perth Hospital and Fiona Stanley Hospital, Perth, Western Australia, Australia. 4. Department of Microbiology and Infectious Diseases, PathWest Laboratory, Royal Perth Hospital and Fiona Stanley Hospital, Perth, Western Australia, Australia. 5. Australian Collaborating Centre for Enterococcus and Staphylococcus Species Typing and Research, School of Veterinary and Life Sciences, Murdoch University, School of Biomedical Sciences, Curtin University, Perth, Western Australia, Australia. 6. Department of Microbiology and Infectious Diseases, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. 7. School of Population Health, University of Western Australia, Crawley, Western Australia, Australia. 8. School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia.
Abstract
BACKGROUND: Preliminary studies have reported promising results for the utility of gallium-68 (Ga-68) citrate positron emission tomography-computed tomography (PET-CT) for infection imaging. This technique offers reduced radiation dose to patients, shorter time between injection and imaging and reduced time for image acquisition compared to the 'gold standard' nuclear imaging technique: gallium-67 (Ga-67) citrate scintigraphy. AIMS: To compare the two imaging modalities to ascertain whether Ga-68 citrate PET-CT is of equivalent diagnostic efficacy for bone and joint infection or pyrexia of unknown origin (PUO) and to assess image quality and reporter confidence. METHODS: Patients with PUO and suspected bone or joint infection underwent Ga-67 citrate scintigraphy and Ga-68 citrate PET-CT. Participants were followed up for 3 months to record subsequent treatment, investigations and outcome. RESULTS: 60 patients were recruited to this multicentre prospective study: 32 for bone and joint infection, 28 for PUO. The results show a sensitivity of 81% for Ga-67 citrate scintigraphy and 69% for Ga-68 citrate PET-CT, a specificity of 79% for Ga-67 citrate and 67% for Ga-68 citrate and were concordant for 76% of the participants. The reporting physician confidence was significantly lower for Ga-68 citrate (P < 0.05), frequently due to prominent physiologic blood pool activity adjacent to the site of infection. CONCLUSION: The sensitivity and specificity of Ga-68 citrate PET-CT were found to be consistently lower than Ga-67 citrate scintigraphy. Additionally, due to the insufficient level of confidence of the reporting physicians for the Ga-68 citrate PET-CT, this modality could not currently be recommended to replace Ga-67 citrate scintigraphy for routine clinical use.
BACKGROUND: Preliminary studies have reported promising results for the utility of gallium-68 (Ga-68) citrate positron emission tomography-computed tomography (PET-CT) for infection imaging. This technique offers reduced radiation dose to patients, shorter time between injection and imaging and reduced time for image acquisition compared to the 'gold standard' nuclear imaging technique: gallium-67 (Ga-67) citrate scintigraphy. AIMS: To compare the two imaging modalities to ascertain whether Ga-68 citrate PET-CT is of equivalent diagnostic efficacy for bone and joint infection or pyrexia of unknown origin (PUO) and to assess image quality and reporter confidence. METHODS:Patients with PUO and suspected bone or joint infection underwent Ga-67 citrate scintigraphy and Ga-68 citrate PET-CT. Participants were followed up for 3 months to record subsequent treatment, investigations and outcome. RESULTS: 60 patients were recruited to this multicentre prospective study: 32 for bone and joint infection, 28 for PUO. The results show a sensitivity of 81% for Ga-67 citrate scintigraphy and 69% for Ga-68 citrate PET-CT, a specificity of 79% for Ga-67 citrate and 67% for Ga-68 citrate and were concordant for 76% of the participants. The reporting physician confidence was significantly lower for Ga-68 citrate (P < 0.05), frequently due to prominent physiologic blood pool activity adjacent to the site of infection. CONCLUSION: The sensitivity and specificity of Ga-68 citrate PET-CT were found to be consistently lower than Ga-67 citrate scintigraphy. Additionally, due to the insufficient level of confidence of the reporting physicians for the Ga-68 citrate PET-CT, this modality could not currently be recommended to replace Ga-67 citrate scintigraphy for routine clinical use.
Authors: Matthew F L Parker; Justin M Luu; Brailee Schulte; Tony L Huynh; Megan N Stewart; Renuka Sriram; Michelle A Yu; Salma Jivan; Peter J Turnbaugh; Robert R Flavell; Oren S Rosenberg; Michael A Ohliger; David M Wilson Journal: ACS Cent Sci Date: 2020-02-04 Impact factor: 14.553
Authors: Ilona Polvoy; Robert R Flavell; Oren S Rosenberg; Michael A Ohliger; David M Wilson Journal: J Nucl Med Date: 2020-08-06 Impact factor: 11.082
Authors: Tolulope A Aweda; Zumrut F B Muftuler; Adriana V F Massicano; Dhruval Gadhia; Kelly A McCarthy; Stacy Queern; Anupam Bandyopadhyay; Jianmin Gao; Suzanne E Lapi Journal: Contrast Media Mol Imaging Date: 2019-10-29 Impact factor: 3.161