18FDG-PET: a new diagnostic approach in hip prosthesis infection

“…Reviewing titles and abstracts from PubMed/MEDLINE revealed 20 articles potentially eligible for inclusion [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Reviewing titles and abstracts from Embase revealed 17 articles potentially eligible for inclusion, which were all already identified by the PubMed/MEDLINE search.…”

Section: Literature Searchmentioning

confidence: 99%

“…However, this article was excluded because less than 15 patients with hip and/or knee prostheses were investigated [32]. Thus, eventually 11 studies [12,13,15,17,19,20,23,24,27,28,30], comprising a total sample size of 635 prostheses, met all inclusion and exclusion criteria, and they were included in this systematic review. The characteristics of the included studies are presented in Tables 3, 4, and 5.…”

Section: Literature Searchmentioning

confidence: 99%

FDG-PET for diagnosing prosthetic joint infection: systematic review and metaanalysis

Kwee

Kwee²,

Alavi

2008

Eur J Nucl Med Mol Imaging

131

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Purpose The aim of this study was to systematically review and metaanalyze published data on the diagnostic performance of 18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in detecting prosthetic hip or knee joint infection. Methods A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Two reviewers independently assessed the methodological quality of each study. A metaanalysis of the reported sensitivity and specificity of each study was performed. Subgroup analyses were performed if results of individual studies were heterogeneous. Results The inclusion criteria were met by 11 studies; there was a total sample size of 635 prostheses. Overall, the studies had good methodological quality. Pooled sensitivity and specificity of FDG-PET for the detection of prosthetic hip or knee joint infection were 82.1% (95%CI=68.0-90.8%) and 86.6% (95%CI=79.7-91.4%), respectively. Heterogeneity among the results of individual studies was present (I 2 =68.8%). Diagnostic performance was influenced by type of joint prostheses (hip prostheses vs. knee prostheses) and type of reconstruction method used (filtered back vs. iterative) (p=0.0164 and p=0.0235, respectively). Conclusion In this metaanalysis, overall diagnostic performance of FDG-PET was moderate to high. Caution is warranted, however, because results of individual studies were heterogeneous and could not be fully explored. Future studies should further explore potential causes of heterogeneity and validate the use of FDG-PET for diagnosing prosthetic joint infection.

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“…Stumpe et al [50] and Love et al [24] reported accuracies of only 69% and 71% in diagnosing lower joint infections with 18 F-FDG, respectively. In addition, Garcia-Barrechguren et al [51] demonstrated a sensitivity and specificity of 64% and 67%, respectively in patients being tested for prosthetic hip infection. Moreover, Stumpe et al [52] and Delank et al [53] concluded in their studies that 18 F-FDG PET is not specific for infection.…”

Section: Originalmentioning

confidence: 99%