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Added value of 18F-FDG PET/CT in diagnosing infected hip prosthesis

(2018) ACTA RADIOLOGICA. 59(5). p.569-576
Author
Organization
Abstract
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.
Keywords
Prosthesis, arthroplasty, hip joint, infection, 18-fluoro-deoxyglucose positron emission tomography (18F-FDG PET), OPERATING CHARACTERISTIC CURVES, FDG PET, KNEE PROSTHESES, JOINT INFECTION, ARTHROPLASTY, METAANALYSIS, REPLACEMENT

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MLA
Kwee, Robert M, Wouter AM Broos, Boudewijn Brans, et al. “Added Value of 18F-FDG PET/CT in Diagnosing Infected Hip Prosthesis.” ACTA RADIOLOGICA 59.5 (2018): 569–576. Print.
APA
Kwee, R. M., Broos, W. A., Brans, B., Walenkamp, G. H., Geurts, J., & Weijers, R. E. (2018). Added value of 18F-FDG PET/CT in diagnosing infected hip prosthesis. ACTA RADIOLOGICA, 59(5), 569–576.
Chicago author-date
Kwee, Robert M, Wouter AM Broos, Boudewijn Brans, Geert HIM Walenkamp, Jan Geurts, and René E Weijers. 2018. “Added Value of 18F-FDG PET/CT in Diagnosing Infected Hip Prosthesis.” Acta Radiologica 59 (5): 569–576.
Chicago author-date (all authors)
Kwee, Robert M, Wouter AM Broos, Boudewijn Brans, Geert HIM Walenkamp, Jan Geurts, and René E Weijers. 2018. “Added Value of 18F-FDG PET/CT in Diagnosing Infected Hip Prosthesis.” Acta Radiologica 59 (5): 569–576.
Vancouver
1.
Kwee RM, Broos WA, Brans B, Walenkamp GH, Geurts J, Weijers RE. Added value of 18F-FDG PET/CT in diagnosing infected hip prosthesis. ACTA RADIOLOGICA. 2018;59(5):569–76.
IEEE
[1]
R. M. Kwee, W. A. Broos, B. Brans, G. H. Walenkamp, J. Geurts, and R. E. Weijers, “Added value of 18F-FDG PET/CT in diagnosing infected hip prosthesis,” ACTA RADIOLOGICA, vol. 59, no. 5, pp. 569–576, 2018.
@article{8553970,
  abstract     = {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.},
  author       = {Kwee, Robert M and Broos, Wouter AM and Brans, Boudewijn and Walenkamp, Geert HIM and Geurts, Jan and Weijers, René E},
  issn         = {0284-1851},
  journal      = {ACTA RADIOLOGICA},
  keywords     = {Prosthesis,arthroplasty,hip joint,infection,18-fluoro-deoxyglucose positron emission tomography (18F-FDG PET),OPERATING CHARACTERISTIC CURVES,FDG PET,KNEE PROSTHESES,JOINT INFECTION,ARTHROPLASTY,METAANALYSIS,REPLACEMENT},
  language     = {eng},
  number       = {5},
  pages        = {569--576},
  title        = {Added value of 18F-FDG PET/CT in diagnosing infected hip prosthesis},
  url          = {http://dx.doi.org/10.1177/0284185117726812},
  volume       = {59},
  year         = {2018},
}

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