Attenuation-Correction Induced Artifact in F-18 FDG PET Imaging Following Total Knee Replacement

Heiba, Sherif; Luo, Jianqiao; Sadek, Samy; Macalental, Eric; Cacavio, Adrienne; Rosen, Gerald; Abdel-Dayem, Hussein

doi:10.1016/s1095-0397(01)00054-1

Cited by 34 publications

(20 citation statements)

References 9 publications

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“…The presence of artifacts on attenuation-corrected images has also been observed in knee prostheses; in a phantom study, Van Acker et al [28] showed that artifacts mimicking FDG uptake adjacent to a knee prosthesis can arise in attenuation-corrected images obtained with different methods of image reconstruction. In addition, Heiba et al [35] reported the observation of an artifact within the joint space of total knee metallic prostheses in two patients on attenuationcorrected images. No uptake, however, was noted in the same location on the nonattenuation-corrected images [35].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Heiba et al [35] reported the observation of an artifact within the joint space of total knee metallic prostheses in two patients on attenuationcorrected images. No uptake, however, was noted in the same location on the nonattenuation-corrected images [35]. Thus, verification of attenuation-corrected images against nonattenuation-corrected images may avoid false-positive results because of the abovementioned reasons.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Kwee

Kwee²,

Alavi

2008

Eur J Nucl Med Mol Imaging

131

View full text Add to dashboard Cite

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“…For patients with metallic implants, 18 F-FDG PET has an advantage over other imaging modalities since FDG uptake is not hampered by metallic artifacts [12]. However, 18 F-FDG PET/ CT has several limitations for detecting local recurrence in patients treated with endoprosthetic replacement due to the increased FDG uptake around the prosthesis, irrespective of local recurrence [13,14].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of increased 18F-FDG uptake for detecting local recurrence in patients with extremity osteosarcoma treated with surgical resection and endoprosthetic replacement

et al. 2014

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“…Moreover, their clinical significance in oncological imaging has not been studied thoroughly compared with other metallic objects such as dental metallic implants [6,15,16] and orthopedic prostheses [12,17]. Some studies reported that pacemakers might induce falsely increased uptake at the site of the implant [18,19] which can be misinterpreted as a metabolically active tumour or metastatic deposit.…”

Section: Introductionmentioning

confidence: 99%

Qualitative and Quantitative Assessment of Metal Artifacts Arising from Implantable Cardiac Pacing Devices in Oncological PET/CT Studies: A Phantom Study

Mehranian

Abdoli

et al. 2011

Mol Imaging Biol

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Purpose: We evaluate the magnitude of metallic artifacts caused by various implantable cardiac pacing devices (without leads) on both attenuation maps (μ-maps) and positron emission tomography (PET) images using experimental phantom studies. We also assess the efficacy of a metal artifact reduction (MAR) algorithm along with the severity of artifacts in the presence of misalignment between μ-maps and PET images. Methods: Four pacing devices including two pacemakers (pacemakers 1 and 2) and two cardiac resynchronization therapy (CRT) devices of pacemaker (CRT-P) and defibrillator (CRT-D) type were placed in three phantoms including a cylindrical Ge-68 phantom, a water-bath phantom and an anthropomorphic heart/thorax phantom. The μ-maps were derived from computed tomography (CT) images reconstructed using the standard method supplied by the manufacturer and those reconstructed using the MAR algorithm. In addition, the standard reconstructed CT images of the last two phantoms were manually misaligned by 10 mm along the patient's axis to simulate misalignment between CT and PET images. Results: The least and severest artifacts produced on both μ-maps and PET images of the Ge-68 phantom were induced by CRT-P and pacemaker 1 devices, respectively. In the water-bath phantom, CRT-P induced 17.5% over-and 9.2% underestimation of tracer uptake whereas pacemaker 1 induced 69.6% over-and 65.7% underestimation. In the heart/thorax phantom representing a pacemaker-bearing patient, pacemaker 1 induced 41.8% increase and 36.6% decrease in tracer uptake and attenuation coefficients on average in regions corresponding to bright and dark streak artifacts, respectively. Statistical analysis revealed that the MAR algorithm was successful in reducing bright streak artifacts, yet unsuccessful for dark ones. In the heart/thorax phantom, the MAR algorithm reduced the overestimations to 4.4% and the underestimations to 35.5% on average. Misalignment between μ-maps and PET images increased the peak of pseudo-uptake by approximately 20%.Correspondence to: Mohammad R. Ay; e-mail: mohammadreza_ay@tums.ac.irConclusions: This study demonstrated that, depending on their elemental composition, different implantable cardiac pacing devices result in varying magnitudes of metal artifacts and thus pseudo-uptake on PET images. The MAR algorithm was not successful in compensating for underestimations which calls for a more efficient algorithm. The results showed that misalignments between PET and CT images render metal-related pseudo-uptake more severe.

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Attenuation-Correction Induced Artifact in F-18 FDG PET Imaging Following Total Knee Replacement

Cited by 34 publications

References 9 publications

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

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

Usefulness of increased 18F-FDG uptake for detecting local recurrence in patients with extremity osteosarcoma treated with surgical resection and endoprosthetic replacement

Qualitative and Quantitative Assessment of Metal Artifacts Arising from Implantable Cardiac Pacing Devices in Oncological PET/CT Studies: A Phantom Study

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