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Follenfant E, Balamoutoff N, Lawson-Ayayi S, Dutronc H, Dupon M, Vital JM, Delobel P, Durox H, de Clermont-Gallerande H, Fernandez P, Dauchy FA. Added value of [ 18F]fluorodeoxyglucose positron emission tomography/computed tomography for the diagnosis of post-operative instrumented spine infection. Joint Bone Spine 2019; 86:503-508. [PMID: 30711697 DOI: 10.1016/j.jbspin.2019.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/23/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Post-operative instrumented spine infection (PISI) is an infrequent complication. Diagnosis of spinal implant infection can be difficult, especially in case of chronic infection. METHODS This retrospective study attempts to evaluate the diagnostic performance of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in PISI. Imagings were performed between April 2010 and June 2018 among patients referred for suspected chronic spinal implant infection. PET/CT were performed more than 12 weeks after surgery. PET/CT images were re-interpreted independently by two nuclear medicine physicians without knowledge of the patient's conditions. PET/CT data were analyzed both visually and semi-quantitatively (SUVmax). MRI results were collected from medical records. The final diagnosis of infection was based on bacteriological cultures or a twelve-month follow-up. RESULTS Forty-nine PET/CT were performed in 44 patients (22 women, median age 65.0 years). Twenty-two patients had a diagnosis of infection during follow-up. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for PET/CT were 86.4%, 81.5%, 79.2%, and 88.0%. Sensitivity, specificity, PPV and NPV were 66.7%, 75.0%, 66.0%, 75.0% respectively for MRI and 50.0%, 92.6%, 84.6% and 69.4% for serum C-reactive protein (CRP). Although these values were higher for PET/CT than for MRI or CRP, the differences were not statistically significant. In this setting, false positives with PET/CT can be observed in case of previous spine infection or adjacent segments disc disease. False negatives can result of extensive instrumented arthrodesis or infection with low virulence bacteria. CONCLUSION PET/CT is useful for the diagnosis of PISI. These results should be evaluated in further prospective study.
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Affiliation(s)
- Emilie Follenfant
- Department of infectious and tropical diseases, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France; Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France
| | - Nicolas Balamoutoff
- Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France; Service de médecine nucléaire, hôpital Pellegrin, 33076 Bordeaux, France; INCIA, UMR, CNRS 5287, université de Bordeaux, 33076 Bordeaux, France
| | - Sylvie Lawson-Ayayi
- Inserm U1219 Bordeaux population health, ISPED, university of Bordeaux, 33076 Bordeaux, France
| | - Hervé Dutronc
- Department of infectious and tropical diseases, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France; Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France
| | - Michel Dupon
- Department of infectious and tropical diseases, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France; Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France
| | - Jean-Marc Vital
- Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France; Spine unit one, orthopaedic surgery, hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Pierre Delobel
- Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France; Department of infectious and tropical diseases, CHU de Toulouse, Toulouse, France
| | - Hélène Durox
- Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France; Department of infectious and tropical diseases, CHU de Limoges, Limoges, France
| | - Henri de Clermont-Gallerande
- Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France; Service de médecine nucléaire, hôpital Pellegrin, 33076 Bordeaux, France; INCIA, UMR, CNRS 5287, université de Bordeaux, 33076 Bordeaux, France
| | - Philippe Fernandez
- Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France; Service de médecine nucléaire, hôpital Pellegrin, 33076 Bordeaux, France; INCIA, UMR, CNRS 5287, université de Bordeaux, 33076 Bordeaux, France
| | - Frédéric-Antoine Dauchy
- Department of infectious and tropical diseases, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France; Centre de référence infections ostéo-articulaires complexes du Grand Sud-Ouest (Crioac GSO), 33076 Bordeaux, France; Inserm U1219 Bordeaux population health, ISPED, university of Bordeaux, 33076 Bordeaux, France.
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Blain S, Guillou J, Tréguer P, Woerther P, Delauney L, Follenfant E, Gontier O, Hamon M, Leilde B, Masson A, Tartu C, Vuillemin R. High frequency monitoring of the coastal marine environment using the MAREL buoy. ACTA ACUST UNITED AC 2004; 6:569-75. [PMID: 15173911 DOI: 10.1039/b314073c] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The MAREL Iroise data buoy provides physico-chemical measurements acquired in surface marine water in continuous and autonomous mode. The water is pumped 1.5 m from below the surface through a sampling pipe and flows through the measuring cell located in the floating structure. Technological innovations implemented inside the measuring cell atop the buoy allow a continuous cleaning of the sensor, while injection of chloride ions into the circuit prevents biological fouling. Specific sensors for temperature, salinity, oxygen and fluorescence investigated in this paper have been evaluated to guarantee measurement precision over a 3 month period. A bi-directional link under Internet TCP-IP protocols is used for data, alarms and remote-control transmissions with the land-based data centre. Herein, we present a 29 month record for 4 parameters measured using a MAREL buoy moored in a coastal environment (Iroise Sea, Brest, France). The accuracy of the data provided by the buoy is assessed by comparison with measurements of sea water weekly sampled at the same site as part of SOMLIT (Service d'Observation du Milieu LIToral), the French network for monitoring of the coastal environment. Some particular events (impact of intensive fresh water discharges, dynamics of a fast phytoplankton bloom) are also presented, demonstrating the worth of monitoring a highly variable environment with a high frequency continuous reliable system.
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Affiliation(s)
- S Blain
- Centre Océanologique de Marseille, LOB, UMR CNRS 6535, campus de Luminy, case 901, F-13288 Marseille Cedex 09, France.
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