Added value of 18F-FDG PET/CT in diagnosing infected hip prosthesis
Autor: | Robert M. Kwee, Jan Geurts, René E. Weijers, Geert H I M Walenkamp, Boudewijn Brans, Wouter Am Broos |
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Přispěvatelé: | MUMC+: DA Beeldvorming (5), Health Services Research, MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, Orthopedie, MUMC+: MA Orthopedie (9) |
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Adult
Male medicine.medical_specialty Prosthesis-Related Infections medicine.medical_treatment Radiography Physical examination Blood Sedimentation Suction Prosthesis 030218 nuclear medicine & medical imaging 03 medical and health sciences Leukocyte Count 0302 clinical medicine Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography medicine Humans Radiology Nuclear Medicine and imaging Abscess Aged Retrospective Studies Aged 80 and over 030222 orthopedics Radiological and Ultrasound Technology Receiver operating characteristic medicine.diagnostic_test business.industry General Medicine Gold standard (test) Middle Aged medicine.disease Arthroplasty C-Reactive Protein Erythrocyte sedimentation rate Female Radiology Hip Prosthesis Radiopharmaceuticals business |
Zdroj: | Acta Radiologica, 59(5), 569-576. SAGE Publications Ltd |
ISSN: | 0284-1851 |
Popis: | Background The diagnosis of infected hip prosthesis is frequently not straightforward yet very important as it changes treatment. Purpose To retrospectively investigate the added value of 18F-FDG PET/CT to conventional tests including radiography, erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) testing, and joint aspiration, in diagnosing infected hip prosthesis. Material and Methods Seventy-eight hip prostheses of 78 patients (55% men; mean age = 66.5 years; age range = 30–85 years) with non-specific clinical presentation, i.e. no abscess or sinus tract communicating with the joint space at clinical examination, were analyzed. Cultures of intra-articular fluid and peri-implant tissues after revision surgery or clinical follow-up ≥6 months served as gold standard. Areas under the receiver operating characteristic curves (AUCs) of radiography, ESR/CRP testing, aspiration culture, and white blood cell (WBC) count without and with the addition of 18F-FDG PET/CT were compared. Results The addition of 18F-FDG PET/CT increased AUCs: for radiography with 0.212, P = 0.001; for ESR/CRP testing with 0.076, P = 0.072; for aspiration culture with 0.126, P = 0.032; and for aspiration WBC count with 0.191, P = 0.035. Conclusion This study shows that 18F-FDG PET/CT adds to individual conventional tests in diagnosing infected hip prosthesis. It may improve the preoperative planning and should therefore be considered in the diagnostic work-up. Future studies should define the exact place of 18F-FDG PET/CT in the diagnostic work-up of periprosthetic joint infection. |
Databáze: | OpenAIRE |
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