FDG-PET in infectious and inflammatory disease

Excerpt

Nearly a thousand years ago the Danish King Knut ruled an empire which included Scandinavia, Scotland, England, Ireland and part of France. His sycophantic advisors declared he was the greatest king who had ever lived: he was so important and powerful that even the seas would be under his command. He tried to answer this adulation by saying that he was only a man, like all others. In the end, to prove a point to the advisors who said that he was so powerful that even the tides would obey his command, he had his throne brought to the edge of the sea. As every child knows, all that happened was that poor Knut got wet feet and proved his humanity to his courtiers. Just like Knut, those who argue that PET is not routinely indicated for use in infection are facing an inevitable tide of practice which is resulting in the adoption of a new methodology despite only a minimum of evidence to support its use. A common criticism levelled at those without a particular technology is that they will always find arguments to justify not using that technology. However, whilst we admit to not having PET machines in our departments, we ensure that patients from our institutions have access to PET imaging at neighbouring units. At present about 20 patients/department are sent for PET imaging each month, but none of these patients has been imaged to identify infection. There are three main reasons for this: Each of these reasons is discussed in some detail below. …