Application of 99mTc-UBI 29-41 scintigraphy in knee periprosthetic infection diagnosis
| Autor: | Kamran Aryana, Mohammad Gharedaghi, Royasadat Alavi, Zahra Kiamanesh, Narjess Ayati |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Prosthesis-Related Infections Adolescent medicine.medical_treatment Periprosthetic Osteoarthritis Scintigraphy Prosthesis 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Medicine Humans Radiology Nuclear Medicine and imaging Knee Young adult Arthroplasty Replacement Knee Radionuclide Imaging Aged medicine.diagnostic_test business.industry Chronic pain General Medicine Organotechnetium Compounds Middle Aged Osteoarthritis Knee medicine.disease Arthroplasty 030220 oncology & carcinogenesis Orthopedic surgery Female Radiology business Oligopeptides |
| Zdroj: | Nuklearmedizin. Nuclear medicine. 58(4) |
| ISSN: | 2567-6407 |
| Popis: | Aim In recent years, the use of total knee arthroplasty (TKA) is considered a safe and cost-effective orthopedic procedure for alleviating the chronic pain and treatment of progressive osteoarthritis. This procedure may have some complications including periprosthetic infection as the most serious and aseptic loosening as the most common one. Differentiating between these entities is important because each has a different therapeutic approach. This study was conducted to investigate the ability of 99mTC-UBI scan to distinguish septic from aseptic loosening in a painful knee prosthesis. Methods 34 patients with painful knee prostheses were included. The 99mTC-UBI scan was done immediately after IV administration of 99mTC-UBI in early dynamic and 30-minute static images. Time-activity curve (TAC) was drawn for all patients and target to non-target ratio (T/NT) was calculated on 30-minute images. The final diagnosis was confirmed by surgical findings, microbiologic culture results or active clinical follow up. Results Using TAC analysis, 24 99mTC-UBI scans were considered negative and 10 positive for an infectious process. Sensitivity, specificity, negative and positive predictive values were 56 %, 80 %, 83 %, and 50 %, respectively. T/NT ratio analysis on 30-minute static images demonstrated 9 positive and 25 negative patterns, with a cut off value of 1.83 for the T/NT ratio. The sensitivity, specificity, negative and positive predictive values, and accuracy of this test modality were all 100 %. Conclusions Our findings show 99mTc-UBI scan is an excellent clinical diagnostic test for differentiating septic from aseptic loosening of the knee prostheses with perfect sensitivity and specificity. Highly accurate results were obtained only 30 minutes after injection. |
| Databáze: | OpenAIRE |
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