{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:18:24Z","timestamp":1787872704143,"version":"build-2784847793"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Physiologic healing processes and foreign body reactions can mimic infective conditions in 18F-FDG-PET\/CT for the detection of deep sternal wound infections. To date, nothing is known about the metabolic presentation of surgically applied bone wax to the sternum for hemostasis during sternotomy in 18F-FDG-PET\/CT imaging. Therefore, this study aims to assess the sternal FDG uptake after the application of bone wax during sternotomy.<\/jats:p>\n                  <jats:p>A total of 25 patients with a history of cardiac surgery (1.3\u20135.5 years ago) were examined by 18F-FDG-PET\/CT with dual time point imaging. The sternal FDG uptake was assessed visually (as positive or negative) and metrically using the maximum standardized uptake values (SUVmax) calculated automatically. The SUVmax was compared between the patients with and without the use of bone wax and among patients with and without positive sternal findings in the visual analysis. A correlation analysis was performed between the time since surgery and the sternal SUVmax.<\/jats:p>\n                  <jats:p>In all eight patients (32%) had received bone wax. In those patients, the mean sternal SUVmax was higher compared to the group without bone wax, both in the early (4.74\u2009\u00b1\u20091.28 vs. 3.70\u2009\u00b1\u20091.44; p\u2009=\u20090.0969) and in the late images (6.62\u2009\u00b1\u20092.67 vs. 4.36\u2009\u00b1\u20091.44; p\u2009=\u20090.0289). Moreover, the use of bone wax was strongly associated with positive sternal findings in the visual analysis (OR\u2009=\u200910; 95%CI\u2009=\u20090.995\u2013100.462; p\u2009=\u20090.0421). The correlation analysis revealed a slightly decreasing trend without significance (Spearman's \u03c1\u2009=\u2009\u22120.139; p\u2009=\u20090.505).<\/jats:p>\n                  <jats:p>The use of bone wax during sternotomy could be associated with increased sternal uptake of FDG on 18F-FDG-PET\/CT, even several years after surgery. This finding should be considered in the evaluation of potential deep sternal wound infections.<\/jats:p>","DOI":"10.1055\/a-2796-6952","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:17:38Z","timestamp":1769645858000},"page":"485-491","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced Uptake of FDG in PET\/CT After the Use of Bone Wax During Sternotomy"],"prefix":"10.1055","volume":"74","author":[{"given":"Michael","family":"J\u00fcptner","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4992-818X","authenticated-orcid":false,"given":"Bernd","family":"Panholzer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette","family":"Friedrichs","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Infectious Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Warnecke","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Cremer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Thiem","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"L\u00fctzen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Sch\u00f6ttler","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0003-4975(10)61822-X","article-title":"Management of infected median sternotomy wounds","volume":"42","author":"P C Pairolero","year":"1986","journal-title":"Ann Thorac Surg"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1016\/j.bjps.2018.07.017","article-title":"Diagnostic value of fluorine-18 deoxyglucose positron emission tomography\/computed tomography in deep sternal wound infection","volume":"71","author":"R Zhang","year":"2018","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s13139-019-00599-6","article-title":"Utility of FDG-PET\/CT for the detection and characterization of sternal wound infection following sternotomy","volume":"53","author":"H Hariri","year":"2019","journal-title":"Nucl Med Mol Imaging"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1007\/s12350-022-03126-x","article-title":"18F-FDG\/PET-CT imaging findings after sternotomy","volume":"30","author":"M SH Blomjous","year":"2023","journal-title":"J Nucl Cardiol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1055\/s-0033-1345278","article-title":"Foreign body reaction with high standard uptake value level in 18-FDG PET\/CT mimicking relapse in an 8-year-old patient diagnosed with Hodgkin lymphoma: a case report","volume":"1","author":"D Erdo\u011fan","year":"2013","journal-title":"European J Pediatr Surg Rep"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.nuclcard.2007.11.009","article-title":"Surgical glue for repair of the aortic root as a possible explanation for increased F-18 FDG uptake","volume":"15","author":"L RA Schouten","year":"2008","journal-title":"J Nucl Cardiol"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1007\/s12350-016-0443-1","article-title":"Evaluation of a low-carbohydrate diet-based preparation protocol without fasting for cardiac PET\/MR imaging","volume":"24","author":"F Nensa","year":"2017","journal-title":"J Nucl Cardiol"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1007\/s00259-024-06915-3","article-title":"EANM\/SNMMI guideline\/procedure standard for [18F]FDG hybrid PET use in infection and inflammation in adults v2.0","volume":"52","author":"G Abikhzer","year":"2025","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"S89","DOI":"10.1007\/s00586-004-0727-z","article-title":"The use of local agents: bone wax, gelatin, collagen, oxidized cellulose","volume":"13","author":"C Schonauer","year":"2004","journal-title":"Eur Spine J"},{"key":"ref10","first-page":"39","article-title":"Haemostasis and healing following median sternotomy","author":"T G Brightmore","year":"1975","journal-title":"Langenbecks Arch Chir"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/0278-2391(92)90443-4","article-title":"Osseous regeneration in the presence of four common hemostatic agents","volume":"50","author":"M D Finn","year":"1992","journal-title":"J Oral Maxillofac Surg"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S1010-5182(87)80020-3","article-title":"Effects of bone wax on rabbit cranial bone lesions","volume":"15","author":"P Alberius","year":"1987","journal-title":"J Craniomaxillofac Surg"},{"issue":"04","key":"ref13","first-page":"389","article-title":"A retroperitoneal tumor as a late complication of the use of bone wax","volume":"66","author":"O Verborgt","year":"2000","journal-title":"Acta Orthop Belg"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1054\/ijom.2002.0394","article-title":"Bone wax as a cause of a foreign body granuloma in a cranial defect: a case report","volume":"32","author":"E B Wolvius","year":"2003","journal-title":"Int J Oral Maxillofac 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Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2796-6952.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:48:27Z","timestamp":1787870907000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2796-6952"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":17,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2026,8,27]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2796-6952","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1,28]]},"published":{"date-parts":[[2026,1,28]]}}}