Accession Number:

ADA618102

Title:

PET-CT Animal Model for Surveillance of Embedded Metal Fragments

Descriptive Note:

Final rept. 1 Aug 2011-31 Jan 2013

Corporate Author:

HENRY M JACKSON FOUNDATION FOR THE ADVANCEMENT OF MILITARY MEDICINE ROCKVILLE MD

Personal Author(s):

Report Date:

2012-12-15

Pagination or Media Count:

31.0

Abstract:

Purpose The purpose of this pilot study was to determine the sensitivity and specificity of small animal Positron Emission Tomography-Computed Tomography PET-CT in identifying metabolic changes in muscle tissue surrounding simulated shrapnel injuries and compare this imaging to traditional x-ray images. Design Experimental design with repeated measures Methods Fischer 344 male rats randomly assigned to three groups, were implanted with weapons grade heavy metal tungsten alloy HMTA pellets, tantalum Ta pellets as the control metal or Sham control without pellet implantation. Rats from each metal category received a series of x-rays and 18F fluoro-2-deoxy-D-glucose FDG PET-CT scans over 16 weeks. Sacrificed animals at each of five time points over a 16 week period had tissue excised for histopathological examination. Sample 32 Fischer 344 male rats 2 Sham , 15 Ta, 15 HMTA Analysis .Standardized uptake value SUV tracer uptake was quantified using the. Image data comparisons were accomplished using Kolmogorov-Smirnov Z, Friedman s ANOVA and Wilcoxon signed-rank tests. Sensitivity and specificity were determined. Receiver Operating Characteristic ROC curve and the area under the curve AUC were calculated. Significance level was set at p .05. Histopathology was assessed by a pathologist, blinded to treatment groups. Findings Increased FDG uptake was associated with an aggressive malignancy in the HMTA implanted rats. There was a significant difference in tracer uptake between the Ta and HMTA animals and also in tracer uptake over the sixteen weeks for the HMTA animals. PET-CT imaging had a sensitivity of 86, specificity of 100 and AUC .938. Implications for Military Nursing Military nurses have a unique opportunity to educate patients and providers about the possibility of early tissue changes around embedded fragments and the use of PET-CT imaging as a possible surveillance tool. When retained shrapnel is located, monitor patients for fragment

Subject Categories:

  • Medicine and Medical Research
  • Ammunition and Explosives

Distribution Statement:

APPROVED FOR PUBLIC RELEASE