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. Le-serment-d&apos;hippocrate,

, Au moment d'être admis(e) à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité

, Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux

, Je respecterai toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité ou leur dignité. Même sous la contrainte

, Je ne tromperai jamais leur confiance et n'exploiterai pas le pouvoir hérité des circonstances pour forcer les consciences

, Reçu(e) à l'intérieur des maisons, je respecterai les secrets des foyers et ma conduite ne servira pas à corrompre les moeurs. Je ferai tout pour soulager les souffrances. Je ne prolongerai pas abusivement les agonies

, Je n'entreprendrai rien qui dépasse mes compétences. Je les entretiendrai et les perfectionnerai pour assurer au mieux les services qui me seront demandés

, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité

, Que les hommes et mes confrères m'accordent leur estime si je suis fidèle à mes promesses

, Added value of [ 18 F]fluorodeoxyglucose positron emission tomography/ computed tomography for the diagnosis of post-operative instrumented spine infection

, 2-Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO), 3-Department of Nuclear Medicine, 4-INSERM, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, 5-Spine Unit One, Department of Infectious and Tropical Diseases

. De-bordeaux, Abstract Background: Post-operative instrumented spine infection (PISI) is an infrequent complication. Diagnosis of spinal implant infection can be difficult, Departement of Infectious and Tropical Diseases

. F]fluorodeoxyglucose, positron emission tomography/computed tomography (PET/CT) in PISI

, among patients referred for suspected spinal implant infection. PET/CT were performed more than 12 weeks after surgery. PET/CT images were re-interpreted independently by two nuclear medicine physicians without knowledge of the patient's conditions. PET/CT data were analyzed both visually and semi-quantitatively (SUVmax), The final diagnosis of infection was based on bacteriological cultures during a twelve-month follow-up, 2010.

, Twenty-two patients had a diagnosis of infection during follow-up. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for PET/CT were 86.4%, 81.5%, 79.2%, and 88.0%. Sensitivity specificity, PPV and NPV were 66.7%, 75.0%, 66.0%, 75.0% respectively for MRI and 80%, 92.6%, 84.6% and 69.4% for serum C-reactive protein (CRP) with a 60 mg/L threshold. Although these values were higher for PET/CT than for MRI or CRP, the differences were not statistically significant. In this setting, false positives with PET/CT can be observed in case of previous spine infection or adjacent segments disc disease. False negatives can result of very extensive arthrodesis or infection with low virulence bacteria

, Keywords: diagnosis, [ 18 F]fluorodeoxyglucose positron emission tomography/computed tomography, implant infection, spine infection