Labeled white blood cell/bone marrow single-photon emission computed tomography with computed tomography fails in diagnosing chronic periprosthetic shoulder joint infection

Falstie-Jensen, Thomas; Daugaard, Henrik; Søballé, Kjeld; Ovesen, Janne; Arveschoug, Anne Kirstine; Lange, Jeppe; Olsen, Birgit Anette; Sørensen, Anne Kathrine Belling; Gormsen, Lars Christian; Zerahn, Bo; Johanssen, H.V.S.; Elmengaard, Brian; Thillemann, Theis Muncholm; Bolvig, Lars

doi:10.1016/j.jse.2018.10.024

Cited by 23 publications

(18 citation statements)

References 21 publications

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“…The LS results were unaffected by current antibiotic treatment or type of pathogen, but the process is expensive and time consuming. Falstie-Jensen et al [69] found a sensitivity of 18% and a specificity of 100% in TSA using WBC/bone marrow single-photon emission computed tomography. The C. acnes infections, however, were not detectable by this method.…”

Section: Leukocytesmentioning

confidence: 99%

Current Clinical Methods for Detection of Peri-Prosthetic Joint Infection

Berns

Barrett

Gardezi

et al. 2020

Surgical Infections

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Background: Currently, one of the most pressing problems in the field of orthopedic surgery is peri-prosthetic joint infection [PJI]. While there are numerous ways to detect PJI, current clinical detection methods differ across institutions and have varying criteria and protocols. Some of these methods include the Modified Musculoskeletal Infection Society system, culturing, polymerase chain reaction, the determination of the presence of certain biomarkers, testing for the presence of alpha defensin peptides, and leukocyte level testing. Methods: This review summarizes the most recent publications in the field of PJI detection to highlight current strengths as well as provide future directions to find the system for the quickest, cost-effective, and most accurate way to diagnose these types of infections. Results: The results of this literature review suggest that, while each method of diagnosis has its advantages, each has various drawbacks as well. Current methods can be expensive, take days to weeks to complete, be prone to contamination, and can produce ambiguous results. Conclusions: The findings in this review emphasize the need for a more comprehensive and accurate system for diagnosing PJI. In addition, the specific comparison of advantages and drawbacks can be useful for researchers and clinicians with goals of creating new diagnostic tests for PJIs, as well as in clinical scenarios to determine the correct treatment for patients.

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Section: Leukocytesmentioning

confidence: 99%

Current Clinical Methods for Detection of Peri-Prosthetic Joint Infection

Berns

Barrett

Gardezi

et al. 2020

Surgical Infections

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“…In this early stage, either WBC scanning or bone marrow scanning is recommended because of their high accuracy and ability to exclude the disease (17,33). However, in a recent study of chronic prosthetic shoulder-joint infection, an extremely low sensitivity of 18% for WBC or bone marrow scanning was found, discouraging this recommendation (37). Figure 2 shows an example of WBC scanning for diagnosis of prosthetic joint infection in a 64-y-old woman after knee replacement.…”

Section: Musculoskeletal Infection-osteomyelitismentioning

confidence: 99%

Nuclear Imaging of Bacterial Infection: The State of the Art and Future Directions

et al. 2020

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the clinical justifications for using nuclear medicine techniques in imaging bacterial infections; (2) the mechanisms of nuclear imaging methods used to detect bacterial infections; and (3) the bacterial-metabolism specific imaging techniques currently under development. Financial Disclosure: Dr. Ohliger travels and speaks for General Electric. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through December 2023. Increased mortality rates from infectious diseases is a growing public health concern. Successful management of acute bacterial infections requires early diagnosis and treatment, which are not always easy to achieve. Structural imaging techniques such as CT and MRI are often applied to this problem. However, these methods generally rely on secondary inflammatory changes and are frequently not specific to infection. The use of nuclear medicine techniques can add crucial complementary information, allowing visualization of infectious pathophysiology beyond morphologic imaging. This review will discuss the current structural and functional imaging techniques used for the diagnosis of bacterial infection and their roles in different clinical scenarios. We will also present several new radiotracers in development, with an emphasis on probes targeting bacteria-specific metabolism. As highlighted by the current coronavirus disease 2019 epidemic, caused by the novel severe acute respiratory syndrome coronavirus 2, similar thinking may apply in imaging viral pathogens; for this case, prominent effects on host proteins, most notably angiotensin-converting enzyme 2, might also provide worthwhile imaging targets.

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“…However, the sensitivity of nuclear imaging techniques can be significantly reduced in low-grade, chronic PJI of the shoulder. In fact, remarkably poor sensitivity of both [ 18 F]-FDG and combined labelled leukocyte/marrow imaging to diagnose chronic, low-grade periprosthetic shoulder infection has been reported, with respective values of 14% and 18% [65,66]. Since there are no data on "high grade" shoulder arthroplasty infections, it is impossible to determine if these results are related to the chronic/low grade presentation of PJI or if it is just a specific feature of shoulder PJI.…”

Section: Is There Any Evidence That Imaging Techniques May Have Diffementioning

confidence: 99%

The Role of Imaging Techniques to Define a Peri-Prosthetic Hip and Knee Joint Infection: Multidisciplinary Consensus Statements

Romanò

Petrosillo

Argento

et al. 2020

JCM

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Diagnosing a peri-prosthetic joint infection (PJI) remains challenging despite the availability of a variety of clinical signs, serum and synovial markers, imaging techniques, microbiological and histological findings. Moreover, the one and only true definition of PJI does not exist, which is reflected by the existence of at least six different definitions by independent societies. These definitions are composed of major and minor criteria for defining a PJI, but most of them do not include imaging techniques. This paper highlights the pros and cons of available imaging techniques—X-ray, ultrasound, computed tomography (CT), Magnetic Resonance Imaging (MRI), bone scintigraphy, white blood cell scintigraphy (WBC), anti-granulocyte scintigraphy, and fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), discusses the added value of hybrid camera systems—single photon emission tomography/computed tomography (SPECT/CT), PET/CT and PET/MRI and reports consensus answers on important clinical questions that were discussed during the Third European Congress on Inflammation/Infection Imaging in Rome, December 2019.

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Labeled white blood cell/bone marrow single-photon emission computed tomography with computed tomography fails in diagnosing chronic periprosthetic shoulder joint infection

Cited by 23 publications

References 21 publications

Current Clinical Methods for Detection of Peri-Prosthetic Joint Infection

Current Clinical Methods for Detection of Peri-Prosthetic Joint Infection

Nuclear Imaging of Bacterial Infection: The State of the Art and Future Directions

The Role of Imaging Techniques to Define a Peri-Prosthetic Hip and Knee Joint Infection: Multidisciplinary Consensus Statements

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