Purpose Preoperative differentiation of prosthetic joint infection (PJI) and aseptic loosening (AL) is challenging. We aimed to evaluate the utility of visual analysis and semi-quantitative parameters of [68Ga]Ga-citrate positron emission tomography/computed tomography (PET/CT) in the differentiation of PJI and AL. Methods Sixteen patients with suspected PJI or AL underwent [68Ga]Ga-citrate PET/CT imaging. Results were evaluated by three nuclear medicine doctors based on (1) visual analysis of the attenuation correction (AC) and non-attenuation correction (NAC) based on tracer uptake intensity and range; (2) maximum standard uptake value (SUVmax) of lesions and the SUVmax of the target area/SUVmax of the non-target area (bone and muscle; T/NT [bone] and T/NT [muscle]). The final diagnosis was based on the Musculoskeletal Infection Society criteria, intraoperative findings, and histopathological and microbiological examinations. Results Overall, 10 (62.5%) and 6 (37.5%) patients were diagnosed with PJI and AL, respectively. Receiver operating characteristic analysis revealed that the areas under the curve for SUVmax, T/NT (bone), and T/NT (muscle) were 0.617 (cut-off = 2.243, P = 0.4312), 0.850 (cut-off = 2.844, P = 0.0052), and 0.850 (cut-off = 5.983, P = 0.0003), respectively. AC, NAC, and T/NT (bone) exhibited high differential diagnostic values (sensitivity, specificity, and accuracy of 90.0%, 83.3%, and 87.5%, respectively). The diagnostic efficacy of T/NT (muscle) was the second highest (sensitivity, specificity, and accuracy of 60.0%, 100%, and 75.0%, respectively). SUVmax demonstrated the poorest diagnostic efficacy (sensitivity, specificity, and accuracy of 70.0%, 66.7%, and 68.8%, respectively). Conclusion Our results suggest that [68Ga]Ga-citrate may differentiate PJI and AL.

In order to explore the clinical efficacy of DOTATATE imaging combined with CGA and BSP in the diagnosis of bone metastasis in patients with NENs, a total of 100 NEN patients treated in our hospital from January 2021 to January 2022 were analyzed. All patients are divided into bone metastasis group and nonmetastasis group according to pathological examination results. The differences of DOTATATE imaging, CGA, and BSP are compared, and ROC curves are obtained to analyze the clinical efficacy of the three indicators in single application and combined diagnosis. The results show that AUC, sensitivity, and specificity of DOTATATE, BSP, and CGA combined diagnosis are higher than those of single diagnosis ( P < 0.05 ). It is clearly evident that DOTATATE test, BSP, and CGA can obtain accurate results in the diagnosis of bone metastasis in NEN patients, and those combined diagnosis can improve the diagnostic efficiency.