Utility of 11C-methionine and 11C-donepezil for imaging of Staphylococcus aureus induced osteomyelitis in a juvenile porcine model: comparison to autologous 111In-labelled leukocytes, 99mTc-DPD, and 18F-FDG

• Published in: American journal of nuclear medicine and molecular imaging 2016-11, Vol.6 (6), p.286-300
• Main Authors: Afzelius, Pia, Alstrup, Aage KO, Schønheyder, Henrik C, Borghammer, Per, Jensen, Svend B, Bender, Dirk, Nielsen, Ole L
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2160-8407

The aim of this study was to compare 11 C-methionine and 11 C-donepezil positron emission tomography (PET) with 111 In-labeled leukocyte and 99 m Tc-DPD (Tc-99m 3,3-diphosphono-1,2-propanedicarboxylic acid) single-photon emission computed tomography (SPECT), and 18 F-fluorodeoxyglucose ( 18 F-FDG) PET to improve detection of osteomyelitis. The tracers’ diagnostic utility where tested in a juvenile porcine hematogenously induced osteomyelitis model comparable to osteomyelitis in children. Five 8-9 weeks old female domestic pigs were scanned seven days after intra-arterial inoculation in the right femoral artery with a porcine strain of Staphylococcus aureus . The sequential scan protocol included Computed Tomography, 11 C-methionine and 11 C-donepezil PET, 99 m Tc-DPD and 111 In-labelled leukocytes scintigraphy, and 18 F-FDG PET. This was followed by necropsy of the pigs and gross pathology, histopathology, and microbial examination. The pigs developed a total of 24 osteomyelitic lesions, 4 lesions characterized as contiguous abscesses and pulmonary abscesses (in two pigs). By comparing the 24 osteomyelitic lesions, 18 F-FDG accumulated in 100%, 111 In-leukocytes in 79%, 11 C-methionine in 79%, 11 C-donepezil in 58%, and 99 m Tc-DPD in none. Overall, 18 F-FDG PET was superior to 111 In-leukocyte SPECT and 11 C-methionine in marking infectious lesions.