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Autoradiographic Quantification of ¹⁸F-FDG Uptake in Experimental Soft-Tissue Abscesses in Rats¹

¹ From the Division of Nuclear Medicine (A.H.K., B.W., G.K.v.S., A.B.), Department of Pathology (M.O.K.), and Institute of Medical Microbiology (J.G.), University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland. From the 2001 RSNA scientific assembly. Received May 11, 2001; revision requested June 11; revision received August 24; accepted September 20. Supported by Novartis-Stiftung, Basel, Switzerland; EMDO-Stiftung, Zurich, Switzerland; and Freie Akademische Gesellschaft, Basel, Switzerland. Address correspondence to A.H.K. (e-mail: achim.kaim@dmr.usz.ch).

PURPOSE: To use semiquantitative autoradiography to investigate fluorodeoxyglucose (FDG) uptake, distribution, and cellular localization in acute, early chronic, and late chronic soft-tissue infections.

MATERIALS AND METHODS: Unilateral calf-muscle abscesses were induced in 12 Sprague-Dawley rats by means of intramuscular inoculation of 0.1 mL of bacterial suspension (Staphylococcus aureus, 1.2 x 10⁹ CFU/mL). Following injection of 130–180 MBq of fluorine 18 FDG, autoradiography of the abscess and contralateral muscle was performed (10-µm section thickness) on days 2, 5, and 9 after infection. Detailed spatial correlation of autoradiographs and histopathologic samples was performed by means of image fusion. Regions of interest were placed in the abscess wall, and measured gray values were converted to kilobecquerels per cubic centimeter according to kilobecquerels of injected activity per gram of body weight, which yielded standardized uptake values (SUVs).

RESULTS: Acute abscess formation was characterized by central necrosis predominantly surrounded by neutrophils and a second necrotic tissue layer that bordered neutrophil infiltrates peripherally. Areas with increased FDG uptake corresponded to cellular inflammatory infiltrates, mainly granulocytes. The corresponding SUV was calculated to be 4.08 ± 0.65 (mean ± SD). Early chronic phase showed mixed cellular infiltrate of granulocytes and macrophages that surrounded central necrosis with interspersed fibroblasts and only residual muscle necrosis layer within the abscess wall. FDG uptake was located where granulocytes and macrophages were present, as in acute infection (SUV = 5.32 ± 2.30). Late chronic infection was characterized by a prominent layer of macrophages around residual central necrosis and fibroblast-enriched granulation tissue delineating the infection from muscle tissue. FDG uptake clearly coincided with the macrophages, and no substantial increase of FDG uptake was detected within fibroblast-enriched granulation tissue. The SUV was calculated as 7.97 ± 0.21. Results of Kruskal-Wallis ANOVA demonstrated that the change in SUV with time was statistically significant (² = 7.42, P < .05).

CONCLUSION: The highest FDG uptake coincides with areas of inflammatory cell infiltrates, predominantly in neutrophils in the acute phase and in macrophages in the chronic phase of soft-tissue infection.

© RSNA, 2002

Index terms: Inflammation, radionuclide studies, 456.1216 • Radionuclide imaging, experimental studies, 456.1216 • Soft tissues, infection, 456.2012 • Soft tissues, radionuclide studies, 456.1216

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