Fluorodeoxyglucose positron emission tomography imaging for diagnosing periprosthetic hip infection: the importance of diagnostic criteria

Abstract

Our results demonstrated that the accuracy of FDG-PET is highly dependent of the diagnostic criteria used for periprosthetic hip infection. Only an acceptable diagnostic accuracy (sensitivity 81%; specificity 94%) was found when increased FDG uptake along the femoral bone-prosthesis-interface was considered positive for infection.

Application of [68Ga]Ga-citrate PET/CT for Differentiating Prosthetic Joint Infection from Aseptic Loosening After Joint Replacement Surgery

“…However, treatment for PJI is more complex, typically requiring two-stage surgery; the rst stage includes implant removal, debridement, and antibiotic treatment, followed by a second-stage revision arthroplasty after control of the infection [3,4]. Therefore, treatment for PJI is protracted, the medical costs are high, and the patients' function and quality of life are signi cantly decreased [11]. An accurate and timely diagnosis is crucial for implementing the correct treatment strategy.…”

“…[ 18 F]FDG is one of the most widely studied positron imaging agents for the diagnosis of complications after prosthesis replacement. It has the advantages of high spatial resolution, good image quality, low radiation dose, and the potential for accurate anatomical localization [4,10,11]. Extensive literature has compared [ 18 F]FDG with [ 68 Ga]Ga-citrate for the diagnosis of bone infection-related diseases, and showed different results [13,16,17,27,28].…”

“…The quality of CT and MRI scans is degraded by metal artefacts around the implant [5,10]. [ 99m Tc]Tc-MDP and [ 18 F]NaF bone imaging usually lacks the speci city to distinguish between various complications after the implantation of a prosthesis, and the tracer uptake caused by physiological bone remodelling following implantation may be present for several years [3,[10][11][12]. Triple-phase bone scintigraphy is limited by the fact that the results obtained are dependent on the diagnostic criteria applied [3].…”

18F-FDG PET for Diagnosing Infections in Prosthetic Joints

“…4). 35,36,38,39 Most studies that have been performed to date have evaluated visual 18 F-FDG uptake patterns associated with aseptic loosening or PJI. There is no accepted standardized uptake value (SUV) threshold to diagnose PJI.…”

Future Perspective of the Application of Positron Emission Tomography-Computed Tomography-MR Imaging in Musculoskeletal Disorders

“…4). 35,36,38,39 Most studies that have been performed to date have evaluated visual 18 F-FDG uptake patterns associated with aseptic loosening or PJI. There is no accepted standardized uptake value (SUV) threshold to diagnose PJI.…”