Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Early Evaluation of Inflammatory Focus and Treatment Response Using 18F-Sodium Fluoride Bone Positron Emission Tomography/Computed Tomography in Patients with Metallic Implants: A Case Report

금속이 삽입된 수술 부위에 발생한 염증 부위에서 18F-Sodium Fluoride 뼈 양전자 방출 단층촬영 기법을 사용한 염증의 조기 발견 및 치료 평가: 증례 보고

  • Moon, Ji Hae (Department of Radiology, Soonchunhyang University Cheonan Hospital) ;
  • Lee, Sang Mi (Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Hong, Chang-Hwa (Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital) ;
  • Lee, Jeong Won (Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital)
  • 문지혜 (순천향대학교 천안병원 영상의학과) ;
  • 이상미 (순천향대학교 천안병원 핵의학과) ;
  • 홍창화 (순천향대학교 천안병원 정형외과) ;
  • 이정원 (가톨릭관동대학교 국제성모병원 핵의학과)
  • Received : 2017.07.03
  • Accepted : 2017.12.07
  • Published : 2018.06.01
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Abstract

We report a case of a 76-year-old woman with elevated serum C-reactive protein levels for two weeks after spinal surgery. $^{99m}Tc$-labeled white blood cell scan and dual $^{18}F$-sodium-fluoride ($^{18}F$-NaF) bone positron emission tomography/computed tomography (PET/CT) were used to detect the site of inflammation. Using non-attenuation corrected images, soft tissue inflammation was detected without metal artifact. Antibiotic treatment attenuated inflammation as seen in an early-phase scan using follow-up $^{18}F$-NaF bone PET/CT. This case demonstrates the role of $^{18}F$-NaF bone PET/CT in the detection of inflammation sites, and can be used to evaluate treatment response in patients with metallic implants.

금속을 삽입한 척추 수술을 받은 76세 여자 환자가 2주 이상 경과 후에도 지속적인 감염이 의심되었다. 염증 부위를 확인하기 위해 백혈구 스캔 및 $^{18}F$-Sodium Fluoride (이하 $^{18}F$-NaF) 뼈 양전자 방출 단층촬영을 시행하여 금속으로 인한 인공산물의 방해없이 연조직 염증임을 확인할 수 있었다. 항생제 치료 후 추적관찰로 시행한 $^{18}F$-NaF 뼈 양전자 방출 단층 촬영의 조기 영상에서 호전된 치료 경과를 판단할 수 있었다. 본 증례는 $^{18}F$-NaF 뼈 양전자 방출 단층촬영을 통해 염증 부위를 찾아낼 뿐 아니라 금속물질이 삽입된 환자에게 치료 후 반응 평가를 확인할 수 있었던 사례이다.

Keywords

Acknowledgement

Supported by : Soonchunhyang University

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