Integrated Imaging (SPECT/CT; PET/CT; MRI) in Infection/Inflammation Spine Pathology

Closed for proposals

Project Type

Coordinated Research Project

Project Code




Approved Date

13 September 2013

Start Date

13 September 2013

Expected End Date

31 January 2018

Completed Date

3 May 2019


Summary of the Background/Research Problem • The prevalence of back pain has increased worldwide.• Low back pain is now the 6th most common cause for global disability-adjusted life years. • There is likely an increase in spinal surgery in the future. • The most serious complication after spinal surgery is spinal infection.• There remains uncertainty about the imaging modality of choice in the diagnosis of post-operative spinal infection.• There is therefore a clear need for research on imaging modality of choice in the diagnosis of post-operative spinal infection.• There has been a worldwide increase in hybrid imaging (SPECT/CT, PET/CT) and MRI.• Taken into account the above mentioned points, with and increasing prevalence of back pain in low-middle income countries,    is likely going to translate -in the near future- into an increased incidence of spinal surgery, and the associated complications    of it, of which infection at the surgical site is the most serious one. Therefore, a CRP to determine the imaging modality of    choice for the diagnosis and assessment of post-operative spinal infection would be extremely beneficial to further improve    health care delivery in member states.  


To assess the role of multimodality imaging (MRI, 99mTc-UBI SPECT/CT, [18F]FDG PET/CT) in the diagnosis of spinal infection after spinal surgery.

Specific objectives

2 To determine if a specific imaging algorithm can be identified for the evaluation of spinal infection after spinal surgery.

1. To determine and compare the diagnostic performance of MRI, 99mTc-UBI SPECT/CT and [18F]FDG PET/CT in the evaluation of suspected infection of the spine after surgery.


This CRP have :
• Increase knowledge of the medical community about the use of imaging in the diagnosis and assessment of post-operative spinal infection.
• Strengthen Radiology and Nuclear Medicine practice for the evaluation of suspected spinal infection in the participating centres.
• Demonstrate that the diagnostic performance of [18F] FDG PET/CT was similar to that of MRI and should lead to a wider use of this metabolic imaging modality, especially in diabetic patients suspected of osteomyelitis.
• Proposed a diagnostic imaging algorithm for postoperative spinal infection.


Although 99mTc-UBI SPECT/CT was found to be disappointing and the most accurate imaging modality between MRI and [18F]FDG PET/CT remains uncertain, this CRP confirmed the importance of early diagnosis of post-operative spinal infections and the critical role played by imaging techniques.

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