The value of (18)FDG-PET for the detection of infected hip prosthesis

We compared the accuracy of fluorine-18 labelled 2-fluoro-2-deoxy- d-glucose positron emission tomography ((18)FDG PET) with that of technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy (LS) in the detection of infected hip prosthesis. Seventeen patients with a hip prosthesis suspec...

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Veröffentlicht in:European journal of nuclear medicine and molecular imaging 2003-05, Vol.30 (5), p.705-715
Hauptverfasser: Vanquickenborne, Benedicte, Maes, Alex, Nuyts, Johan, Van Acker, Frank, Stuyck, Jos, Mulier, Michiel, Verbruggen, Alfons, Mortelmans, Luc
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container_issue 5
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container_title European journal of nuclear medicine and molecular imaging
container_volume 30
creator Vanquickenborne, Benedicte
Maes, Alex
Nuyts, Johan
Van Acker, Frank
Stuyck, Jos
Mulier, Michiel
Verbruggen, Alfons
Mortelmans, Luc
description We compared the accuracy of fluorine-18 labelled 2-fluoro-2-deoxy- d-glucose positron emission tomography ((18)FDG PET) with that of technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy (LS) in the detection of infected hip prosthesis. Seventeen patients with a hip prosthesis suspected for infection were prospectively included and underwent (99m)Tc-methylene diphosphonate bone scintigraphy (BS), LS and an (18)FDG-PET scan within a 2-week period. Seven volunteers with ten asymptomatic hip prostheses were used as a control group and underwent BS and an (18)FDG-PET scan. Bacteriology of samples obtained by surgery or by needle aspiration and/or clinical follow-up for up to 6 months were used as the gold standard. Planar images of BS and LS (4 and 24 h p.i.) were acquired, followed by single-photon emission tomography (SPET) LS images (after 4 h). These images were scored as positive or negative by two experienced readers. The (18)FDG-PET scans of the patients were compared with the tracer distribution pattern in the asymptomatic control group and with BS. A phantom study was performed in order to identify artefacts. For this purpose, three different attenuation correction methods were tested. The combined analysis of the planar BS and LS resulted in a 75% sensitivity and a 78% specificity. The SPET LS images showed a better lesion contrast, resulting in an 88% sensitivity and a 100% specificity, while 24-h planar images were of no additional value. The analysis of PET images alone resulted in an 88% sensitivity and a 78% specificity. The combination of (18)FDG-PET and BS images resulted in an 88% sensitivity and a 67% specificity. Given the presence of small errors near the edge of the metal, which can induce significant artefacts in the corrected emission image, we decided to use the data without attenuation correction. In this preliminary study, (18)FDG-PET scans alone showed the same sensitivity as combined BS and LS, although the specificity was slightly lower.
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source MEDLINE; Springer Nature - Complete Springer Journals
subjects Adult
Aged
Arthroplasty, Replacement, Hip - adverse effects
Female
Fluorodeoxyglucose F18
Hip Joint - diagnostic imaging
Hip Prosthesis - adverse effects
Humans
Leukocytes - diagnostic imaging
Male
Middle Aged
Phantoms, Imaging
Prosthesis-Related Infections - diagnostic imaging
Prosthesis-Related Infections - etiology
Radiopharmaceuticals
Reproducibility of Results
Sensitivity and Specificity
Synovitis - diagnostic imaging
Synovitis - etiology
Technetium Tc 99m Exametazime
Technetium Tc 99m Medronate
Tomography, Emission-Computed - instrumentation
Tomography, Emission-Computed - methods
title The value of (18)FDG-PET for the detection of infected hip prosthesis
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