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F-18-FDG-PET uptake in non-infected total hip prostheses

Gelderman, S. J., Jutte, P. C., Boellaard, R., Ploegmakers, J. J. W., Vallez Garcia, D., Kampinga, G. A., Glaudemans, A. W. J. M. & Wouthuyzen-Bakker, M., 2-Nov-2018, In : Acta Orthopaedica. 89, 6, p. 634-639 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

Background and purpose - F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) can be used in the diagnostic work-up of a patient with suspected periprosthetic joint infection (PJI) but, due to a lack of accurate interpretation criteria, this technique is not routinely applied. Since the physiological uptake pattern of FDG around a joint prosthesis is not fully elucidated, we determined the physiological FDG uptake in non-infected total hip prostheses. Patients and methods - Patients treated with primary total hip arthroplasty (1995-2016) who underwent a FDG-PET/CT for an indication other than a suspected PJI were retrospectively evaluated. Scans were both visually and quantitatively analyzed. Semi-quantitative analysis was performed by calculating maximum and peak standardized uptake values (SUVmax and SUVpeak) by volume of interests (VOIs) at 8 different locations around the prosthesis. Results - 58 scans from 30 patients were analyzed. In most hips, a diffuse heterogeneous uptake pattern around the prosthesis was observed (in 32/38 of the cemented prostheses, and in 16/20 of the uncemented prostheses) and most uptake was located around the neck of the prosthesis. The median SUVmax in the cemented group was 2.66 (95% CI 2.51-3.10) and in the uncemented group 2.87 (CI 2.65-4.63) (Median difference = -0.36 [CI -1.2 to 0.34]). In uncemented prostheses, there was a positive correlation in time between the age of the prosthesis and the FDG uptake (r(s) = 0.63 [CI 0.26-0.84]). Interpretation - Our study provides key data to develop accurate interpretation criteria to differentiate between physiological uptake and infection in patients with a prosthetic joint.

Original languageEnglish
Pages (from-to)634-639
Number of pages6
JournalActa Orthopaedica
Volume89
Issue number6
Early online date2018
Publication statusPublished - 2-Nov-2018

    Keywords

  • FDG PET, INFECTION, LEUKOCYTE

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