The value of ^sup 18^F-fluoride PET/CT in the assessment of screw loosening in patients after intervertebral fusion stabilization
We evaluated ^sup 18^F-fluoride PET/CT for the diagnosis of screw loosening after intervertebral fusion stabilization and compared the results with those from functional radiography. A group of 59 patients with pain in the region of previous intervertebral fusion stabilization and suspicion of impla...
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| Veröffentlicht in: | European journal of nuclear medicine and molecular imaging 2015-02, Vol.42 (2), p.272 |
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| creator | Seifen, Tanja Rodrigues, Margarida Rettenbacher, Lukas Piotrowski, Wolfgang Holzmannhofer, Johannes Coy, Mark Mc Pirich, Christian |
| description | We evaluated ^sup 18^F-fluoride PET/CT for the diagnosis of screw loosening after intervertebral fusion stabilization and compared the results with those from functional radiography. A group of 59 patients with pain in the region of previous intervertebral fusion stabilization and suspicion of implant instability due to screw loosening were investigated with ^sup 18^F-fluoride PET/CT and functional radiography, 30.1±3.4 and 29.3±3.2 months, respectively, after surgery. The criterion for loosening was increased focal uptake surrounding the screw entry point and shaft. SUV^sub max^ and SUV^sub mean^ were measured in a region of interest (ROI) drawn around each screw (334 screws analysed). The final diagnosis was established by surgical exploration in 27 patients and clinical follow-up after intervertebral fusion stabilization in 32 patients. Of the 59 patients, 20 were proven positive for implant failure due to screw loosening and 39 were confirmed negative. The sensitivity, specificity and accuracy of ^sup 18^F-fluoride PET/CT were 75 %, 97.4 % and 89.8 % in the patient-based analysis, and 45.6 %, 100 % and 80 % in the screw-based analysis, respectively. The positive and negative predictive values were 93.8 % and 100 % in the patient-based analysis, and 88.4 and 76 % in the screw-based analysis, respectively. CT signs in PET/CT allowed screw breakage to be detected in three patients. SUV^sub max^, SUV^sub mean^ and SUV^sub max^/SUV^sub mean^ ratios in screw ROIs and respective values in reference regions were all found to be significantly different between screws positive for loosening (58 screws) and screws negative for loosening (276 screws). The ratio between SUV^sub max^ in screw ROIs and the values in reference regions was the most significant parameter for distinguishing screws positive and screws negative for loosening. ^sup 18^F-Fluoride PET/CT imaging is useful for the diagnosis of screw loosening in patients with persistent symptoms after intervertebral fusion stabilization. |
| doi_str_mv | 10.1007/s00259-014-2904-6 |
| format | Article |
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A group of 59 patients with pain in the region of previous intervertebral fusion stabilization and suspicion of implant instability due to screw loosening were investigated with ^sup 18^F-fluoride PET/CT and functional radiography, 30.1±3.4 and 29.3±3.2 months, respectively, after surgery. The criterion for loosening was increased focal uptake surrounding the screw entry point and shaft. SUV^sub max^ and SUV^sub mean^ were measured in a region of interest (ROI) drawn around each screw (334 screws analysed). The final diagnosis was established by surgical exploration in 27 patients and clinical follow-up after intervertebral fusion stabilization in 32 patients. Of the 59 patients, 20 were proven positive for implant failure due to screw loosening and 39 were confirmed negative. The sensitivity, specificity and accuracy of ^sup 18^F-fluoride PET/CT were 75 %, 97.4 % and 89.8 % in the patient-based analysis, and 45.6 %, 100 % and 80 % in the screw-based analysis, respectively. The positive and negative predictive values were 93.8 % and 100 % in the patient-based analysis, and 88.4 and 76 % in the screw-based analysis, respectively. CT signs in PET/CT allowed screw breakage to be detected in three patients. SUV^sub max^, SUV^sub mean^ and SUV^sub max^/SUV^sub mean^ ratios in screw ROIs and respective values in reference regions were all found to be significantly different between screws positive for loosening (58 screws) and screws negative for loosening (276 screws). The ratio between SUV^sub max^ in screw ROIs and the values in reference regions was the most significant parameter for distinguishing screws positive and screws negative for loosening. ^sup 18^F-Fluoride PET/CT imaging is useful for the diagnosis of screw loosening in patients with persistent symptoms after intervertebral fusion stabilization.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-014-2904-6</identifier><language>eng</language><publisher>Heidelberg: Springer Nature B.V</publisher><subject>Bone surgery ; Medical diagnosis ; Medical imaging ; Spine ; Tomography ; Transplants & implants ; Vertebrae</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2015-02, Vol.42 (2), p.272</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids></links><search><creatorcontrib>Seifen, Tanja</creatorcontrib><creatorcontrib>Rodrigues, Margarida</creatorcontrib><creatorcontrib>Rettenbacher, Lukas</creatorcontrib><creatorcontrib>Piotrowski, Wolfgang</creatorcontrib><creatorcontrib>Holzmannhofer, Johannes</creatorcontrib><creatorcontrib>Coy, Mark Mc</creatorcontrib><creatorcontrib>Pirich, Christian</creatorcontrib><title>The value of ^sup 18^F-fluoride PET/CT in the assessment of screw loosening in patients after intervertebral fusion stabilization</title><title>European journal of nuclear medicine and molecular imaging</title><description>We evaluated ^sup 18^F-fluoride PET/CT for the diagnosis of screw loosening after intervertebral fusion stabilization and compared the results with those from functional radiography. A group of 59 patients with pain in the region of previous intervertebral fusion stabilization and suspicion of implant instability due to screw loosening were investigated with ^sup 18^F-fluoride PET/CT and functional radiography, 30.1±3.4 and 29.3±3.2 months, respectively, after surgery. The criterion for loosening was increased focal uptake surrounding the screw entry point and shaft. SUV^sub max^ and SUV^sub mean^ were measured in a region of interest (ROI) drawn around each screw (334 screws analysed). The final diagnosis was established by surgical exploration in 27 patients and clinical follow-up after intervertebral fusion stabilization in 32 patients. Of the 59 patients, 20 were proven positive for implant failure due to screw loosening and 39 were confirmed negative. The sensitivity, specificity and accuracy of ^sup 18^F-fluoride PET/CT were 75 %, 97.4 % and 89.8 % in the patient-based analysis, and 45.6 %, 100 % and 80 % in the screw-based analysis, respectively. The positive and negative predictive values were 93.8 % and 100 % in the patient-based analysis, and 88.4 and 76 % in the screw-based analysis, respectively. CT signs in PET/CT allowed screw breakage to be detected in three patients. SUV^sub max^, SUV^sub mean^ and SUV^sub max^/SUV^sub mean^ ratios in screw ROIs and respective values in reference regions were all found to be significantly different between screws positive for loosening (58 screws) and screws negative for loosening (276 screws). The ratio between SUV^sub max^ in screw ROIs and the values in reference regions was the most significant parameter for distinguishing screws positive and screws negative for loosening. ^sup 18^F-Fluoride PET/CT imaging is useful for the diagnosis of screw loosening in patients with persistent symptoms after intervertebral fusion stabilization.</description><subject>Bone surgery</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Spine</subject><subject>Tomography</subject><subject>Transplants & implants</subject><subject>Vertebrae</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNyr1OAzEQBGALgUT4eQC6lahN1pfLna-OElFSXJ3IgTU4MvbhtYNEx5vjSIiaZmc18wlxp_BBIfZzRmyWg0TVymbAVnZnYqY6Ncge9XD-9_d4Ka6YD4hKN3qYie_xjeBofCGIFrZcJlB6u5HWl5jcC8HTepyvRnABcpWGmZjfKeQT5-dEn-BjZAouvJ7QZLKrK4OxmVJt6j1SyrRPxoMt7GIAzmbvvPuqNoYbcWGNZ7r9zWtxv1mPq0c5pfhRiPPuEEsKddqpbokLrZpWLf6nfgDQ7Fdn</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Seifen, Tanja</creator><creator>Rodrigues, Margarida</creator><creator>Rettenbacher, Lukas</creator><creator>Piotrowski, Wolfgang</creator><creator>Holzmannhofer, Johannes</creator><creator>Coy, Mark Mc</creator><creator>Pirich, Christian</creator><general>Springer Nature B.V</general><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20150201</creationdate><title>The value of ^sup 18^F-fluoride PET/CT in the assessment of screw loosening in patients after intervertebral fusion stabilization</title><author>Seifen, Tanja ; 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A group of 59 patients with pain in the region of previous intervertebral fusion stabilization and suspicion of implant instability due to screw loosening were investigated with ^sup 18^F-fluoride PET/CT and functional radiography, 30.1±3.4 and 29.3±3.2 months, respectively, after surgery. The criterion for loosening was increased focal uptake surrounding the screw entry point and shaft. SUV^sub max^ and SUV^sub mean^ were measured in a region of interest (ROI) drawn around each screw (334 screws analysed). The final diagnosis was established by surgical exploration in 27 patients and clinical follow-up after intervertebral fusion stabilization in 32 patients. Of the 59 patients, 20 were proven positive for implant failure due to screw loosening and 39 were confirmed negative. The sensitivity, specificity and accuracy of ^sup 18^F-fluoride PET/CT were 75 %, 97.4 % and 89.8 % in the patient-based analysis, and 45.6 %, 100 % and 80 % in the screw-based analysis, respectively. The positive and negative predictive values were 93.8 % and 100 % in the patient-based analysis, and 88.4 and 76 % in the screw-based analysis, respectively. CT signs in PET/CT allowed screw breakage to be detected in three patients. SUV^sub max^, SUV^sub mean^ and SUV^sub max^/SUV^sub mean^ ratios in screw ROIs and respective values in reference regions were all found to be significantly different between screws positive for loosening (58 screws) and screws negative for loosening (276 screws). The ratio between SUV^sub max^ in screw ROIs and the values in reference regions was the most significant parameter for distinguishing screws positive and screws negative for loosening. ^sup 18^F-Fluoride PET/CT imaging is useful for the diagnosis of screw loosening in patients with persistent symptoms after intervertebral fusion stabilization.</abstract><cop>Heidelberg</cop><pub>Springer Nature B.V</pub><doi>10.1007/s00259-014-2904-6</doi></addata></record> |
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| subjects | Bone surgery Medical diagnosis Medical imaging Spine Tomography Transplants & implants Vertebrae |
| title | The value of ^sup 18^F-fluoride PET/CT in the assessment of screw loosening in patients after intervertebral fusion stabilization |
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