Use of F-18 Fluoride PET to Differentiate Septic From Aseptic Loosening in Total Hip Arthroplasty Patients

Kobayashi, Naomi; Inaba, Yutaka; Choe, Han-Cheol; Ike, Hiroyuki; Fujimaki, Hiroshi; Tezuka, T.; Hirata, Yasuhide; Tateishi, Ukihide; Inoue, Tomio; Saito, T.

doi:10.1097/rlu.0b013e3182291ae7

Cited by 50 publications

(39 citation statements)

References 24 publications

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“…15). They concluded for the first time that fluoride PET has considerable potential as a method to differentiate septic from aseptic loosening following total hip arthroplasty, since the uptake pattern classification system is relatively simply performed [124]. This first rather large-scale study of fluoride PET suggests a potential role in imaging the failed prosthetic joint but, nevertheless, more studies are warranted in the future.…”

Section: Future Applications Of Hybrid Imaging With New Radiotracersmentioning

confidence: 90%

Prosthetic joint infections: radionuclide state-of-the-art imaging

Gemmel¹,

Wyngaert²,

Love

et al. 2012

Eur J Nucl Med Mol Imaging

170

151

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Prosthetic joint replacement surgery is performed with increasing frequency. Overall the incidence of prosthetic joint infection (PJI) and subsequently prosthesis revision failure is estimated to be between 1 and 3%. Differentiating infection from aseptic mechanical loosening, which is the most common cause of prosthetic failure, is especially important because of different types of therapeutic management. Despite a thorough patient history, physical examination, multiple diagnostic tests and complex algorithms, differentiating PJI from aseptic loosening remains challenging. Among imaging modalities, radiographs are neither sensitive nor specific and cross-sectional imaging techniques, such as computed tomography and magnetic resonance imaging, are limited by hardware-induced artefacts. Radionuclide imaging reflects functional rather than anatomical changes and is not hampered by the presence of a metallic joint prosthesis. As a result scintigraphy is currently the modality of choice in the investigation of suspected PJI. Unfortunately, there is no true consensus about the gold standard technique since there are several drawbacks and limitations inherent to each modality. Bone scintigraphy (BS) is sensitive for identifying the failed joint replacement, but cannot differentiate between infection and aseptic loosening. Combined bone/gallium scintigraphy (BS/GS) offers modest improvement over BS alone for diagnosing PJI. However, due to a number of drawbacks, BS/GS has generally been superseded by other techniques but it still may have a role in neutropenic patients. Radiolabelled leucocyte scintigraphy remains the gold standard technique for diagnosing neutrophil-mediated processes. It seems to be that combined in vitro labelled leucocyte/bone marrow scintigraphy (LS/BMS), with an accuracy of about 90%, is currently the imaging modality of choice for diagnosing PJI. There are, however, significant limitations using in vitro labelled leucocytes and considerable effort has been devoted to developing alternative radiotracers, such as radiolabelled HIGs, liposomes, antigranulocyte antibodies and fragments, as well as more investigational tracers such as radiolabelled antibiotics, antimicrobial peptides, bacteriophages and thymidine kinase. On the other hand, positron emission tomography (PET) is still growing in the field of PJI imaging with radiotracers such as (18)F-fluorodeoxyglucose (FDG), (18)F-FDG white blood cells and (18)F-fluoride. But unfortunately this superb tomographic technique will only receive full acceptance when specific PET uptake patterns can be successfully developed. The emergence of hybrid modality imaging using integrated single photon emission computed tomography (SPECT) and PET with computed tomography (SPECT/CT and PET/CT) may also have a contributing role for more accurate assessment of joint replacement complications, especially combined with new radiotracers such as (68)Ga and (64)Cu. Finally, in searching for infection-specific tracers, currently there is no such diagnostic agent available.

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Section: Future Applications Of Hybrid Imaging With New Radiotracersmentioning

confidence: 90%

Prosthetic joint infections: radionuclide state-of-the-art imaging

Gemmel¹,

Wyngaert²,

Love

et al. 2012

Eur J Nucl Med Mol Imaging

170

151

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“…This commonly observed feature has been used to investigate the potential utility of 18 F-NaF PET/CT in this clinical setting. For example, 18 F-NaF PET may be useful in the detection of bone remodeling in early stage osteoarthritis of the temporomandibular and hip joints, ankylosing spondylitis, patellofemoral compartment pain, spontaneous osteonecrosis of the knee, femoral head osteonecrosis, characterization of bone mineralization around joint arthroplasties, early detection of aspetic loosening of total knee arthroplasty, differentiation of septic from aseptic loosening of total hip arthroplasty, and determination of treatment efficacy of bone active agents in patients with diminished bone mineral density (26–36). The osteointegration of cancellous bone allografts in bone defect fillers around the acetabular component of the loosened total hip replacement may also be monitored quantitatively with 18 F-NaF PET (38, 39).…”

Section: Benign Bone Joint and Other Diseasesmentioning

confidence: 99%

Sodium 18F-Fluoride PET/CT of Bone, Joint, and Other Disorders

Jadvar

Desai

Conti

2015

Seminars in Nuclear Medicine

113

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The use of 18F-sodium fluoride (18F-NaF) with positron emission tomography-computed tomography (PET/CT) is increasing. This resurgence of an old tracer has been fueled by several factors including superior diagnostic performance over standard 99mTc-based bone scintigraphy, growth in the availability of PET/CT imaging systems, increase in the number of regional commercial distribution centers for PET radiotracers, the recent concerns about potential chronic shortages with 99mTc based radiotracers, and the recent decision by the Centers for Medicare and Medicaid Services to reimburse for 18F-NaF PET/CT for evaluation of patients with known or suspected bone metastases through the National Oncologic PET Registry. The major goal of this article is to review the current evidence on the diagnostic utility of 18F-NaF in the imaging assessment of bone and joint in a variety of clinical conditions.

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“…Des premiers articles montrent la possibilité d'utiliser la TEP au [ 18 F]-FNa dans le diagnostic d'infection sur prothèse notamment de hanche [48,49]. Les auteurs proposent, comme pour le FDG, des critères d'interprétation en fonction de la distribution du [ 18 F]-FNa autour de la prothèse avec une approche quantitative.…”

Section: La Tomographie Par éMission De Positons (Tep)unclassified