Intrapatient Comparison of 2-Deoxy-2-[F-18]fluoro-d-glucose with Positron EmissionTomography/Computed Tomography to Tc-99m Fanolesomab (NeutroSpec) for Localization of Infection

Abstract

This study evaluated the efficacy of 2-deoxy-2-[F-18]fluoro-D: -glucose (FDG) with positron emission tomography/computed tomography (PET/CT) in comparison with Tc-99m fanolesomab (NeutroSpec) for imaging infection. Twelve patients with possible infection were studied with both FDG-PET/CT and Tc-99m fanolesomab. One patient was studied twice for a total of 13 paired studies. The final determination of the presence or absence of infection and the site(s) of infection at the time of imaging was made by an infectious disease physician using culture results and other relevant information. The sensitivity, specificity, and accuracy were calculated for each imaging study on a per paired study basis and a per lesion basis. In addition, the quality of lesion depicted was compared between the two studies. Three patients were determined not to have infection. Ten paired studies, in nine patients, were determined to have one or more sites of infection: seven had one site and three had two sites. On a per paired study basis the sensitivity, specificity, and accuracy of FDG-PET/CT were all 100%; for Tc-99m fanolesomab these parameters were 30, 100, and 46%, respectively (P < 0.01 for sensitivity and accuracy). On a per site basis the results for FDG-PET/CT were all 100% and for Tc-99m fanolesomab they were 23, 100, and 38% (P < 0.01 for sensitivity and accuracy). In the three sites of infection shown by both studies, FDG-PET/CT was judged to be superior in spatial resolution and anatomic localization compared to Tc-99m fanolesomab in all three sites. FDG-PET/CT is superior to Tc-99m fanolesomab for detecting and localizing sites of infection.