18F-FDG/PET-CT imaging findings after sternotomy

Background. The clinical diagnosis of deep sternal wound infection (DSWI) is supported by imaging findings including 18F-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG-PET/CT). To avoid misinterpretation due to normal post-surgery inflammation we assessed normal imaging findings in non-infected patients after sternotomy. Methods. This is a prospective cohort study including non-infectious patients with sternotomy. All patients underwent F-18-FDG-PET/CT at either 5 weeks (group 1), 12 weeks (group 2) or 52 weeks (group 3) post-surgery. F-18-FDG uptake was scored visually in five categories and assessed quantitatively. Results. A total of 44 patients were included. Sternal mean SUVmax was 7.34 (+/- 1.86), 5.22 (+/- 2.55) and 3.20 (+/- 1.80) in group 1, 2 and 3, respectively (p < 0.01). Sternal mean SUVmean was 3.84 (+/- 1.00), 2.69 (+/- 1.32) and 1.71 (+/- 0.98) in group 1, 2 and 3 (p < 0.01). All patients in group 1 had elevated uptake whereas group 2 and 3 showed 2/15 (13%) and 11/20 (55%) patients respectively with no elevated uptake. Group 3 still showed an elevated uptake pattern in in 9/20 (45%) and in 3/9 (33%) with a high-grade diffuse uptake pattern. Conclusion. This study shows significant lower sternal F-18-FDG at 55 weeks compared to 5 weeks post-sternotomy however elevated uptake patterns may persist.

Automated summary

This study evaluated the normal imaging findings in non-infected patients after sternotomy using F-18-FDG-PET/CT, and found that sternal F-18-FDG uptake decreased significantly from 5 weeks to 55 weeks post-surgery, although elevated uptake patterns may persist.