Utility of F-18 FDG imaging for diagnosing the infected joint replacement

Charito Love, P. V. Pugliese, M. O. Afriyie, M. B. Tomas, S. E. Marwin, C. J. Palestro

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Purpose: F-18 FDG (FDG) is reportedly useful for detecting infection. Because the procedure is simple, with results being readily available, this prospective study was undertaken to evaluate the utility of FDG imaging for diagnosing infected joint replacements. Methods: 26 pts, 18 females and 4 males between 37 and 87 years old, with 31 joint replacements were studied. 21 pts had single joint replacement (10 hip, 11 knee); 5 pts had bilateral replacements (1 hip, 4 knee). Imaging was performed on a Hybrid PET system, with measured attenuation correction, one hour after administration of 150 MBq FDG. Increased peri-prosthetic uptake compared to adjacent, presumably normal, activity was interpreted as positive for infection. Results: 11 of 31 prostheses were infected. Sensitivity, specificity, and accuracy of FDG were 100%, 55%, and 71% respectively. The PPV was 55% and the NPV was 100%. Excluding the 5 asymptomatic prostheses in pts with bilateral joint replacements, the sensitivity, specificity, and accuracy were 100%, 47%, and 69% respectively. The PPV was 58% and the NPV was 100%. 4 pts with infected prostheses underwent a total of 6 follow-up studies after treatment. In 1 pt with persistent infection, all 3 follow-up studies were true positive. In the other 3 pts in whom infection had been eradicated, follow-up FDG studies were false positive. Conclusion: FDG imaging is sensitive but not specific; consequently, its role in pts with suspected prosthetic infection is limited to that of a screening test. These data also suggest that this technique is not useful for monitoring response to treatment.

Original languageEnglish (US)
Pages (from-to)159
Number of pages1
JournalClinical Positron Imaging (Netherlands)
Volume3
Issue number4
DOIs
StatePublished - 2000
Externally publishedYes

Fingerprint

Replacement Arthroplasties
Prostheses and Implants
Infection
Hip
Knee
Sensitivity and Specificity
Prospective Studies
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Utility of F-18 FDG imaging for diagnosing the infected joint replacement. / Love, Charito; Pugliese, P. V.; Afriyie, M. O.; Tomas, M. B.; Marwin, S. E.; Palestro, C. J.

In: Clinical Positron Imaging (Netherlands), Vol. 3, No. 4, 2000, p. 159.

Research output: Contribution to journalArticle

Love, Charito ; Pugliese, P. V. ; Afriyie, M. O. ; Tomas, M. B. ; Marwin, S. E. ; Palestro, C. J. / Utility of F-18 FDG imaging for diagnosing the infected joint replacement. In: Clinical Positron Imaging (Netherlands). 2000 ; Vol. 3, No. 4. pp. 159.
@article{a08a8886ace4482d9ea449d68ac01c7f,
title = "Utility of F-18 FDG imaging for diagnosing the infected joint replacement",
abstract = "Purpose: F-18 FDG (FDG) is reportedly useful for detecting infection. Because the procedure is simple, with results being readily available, this prospective study was undertaken to evaluate the utility of FDG imaging for diagnosing infected joint replacements. Methods: 26 pts, 18 females and 4 males between 37 and 87 years old, with 31 joint replacements were studied. 21 pts had single joint replacement (10 hip, 11 knee); 5 pts had bilateral replacements (1 hip, 4 knee). Imaging was performed on a Hybrid PET system, with measured attenuation correction, one hour after administration of 150 MBq FDG. Increased peri-prosthetic uptake compared to adjacent, presumably normal, activity was interpreted as positive for infection. Results: 11 of 31 prostheses were infected. Sensitivity, specificity, and accuracy of FDG were 100{\%}, 55{\%}, and 71{\%} respectively. The PPV was 55{\%} and the NPV was 100{\%}. Excluding the 5 asymptomatic prostheses in pts with bilateral joint replacements, the sensitivity, specificity, and accuracy were 100{\%}, 47{\%}, and 69{\%} respectively. The PPV was 58{\%} and the NPV was 100{\%}. 4 pts with infected prostheses underwent a total of 6 follow-up studies after treatment. In 1 pt with persistent infection, all 3 follow-up studies were true positive. In the other 3 pts in whom infection had been eradicated, follow-up FDG studies were false positive. Conclusion: FDG imaging is sensitive but not specific; consequently, its role in pts with suspected prosthetic infection is limited to that of a screening test. These data also suggest that this technique is not useful for monitoring response to treatment.",
author = "Charito Love and Pugliese, {P. V.} and Afriyie, {M. O.} and Tomas, {M. B.} and Marwin, {S. E.} and Palestro, {C. J.}",
year = "2000",
doi = "10.1016/S1095-0397(00)00071-6",
language = "English (US)",
volume = "3",
pages = "159",
journal = "Molecular Imaging and Biology",
issn = "1536-1632",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - Utility of F-18 FDG imaging for diagnosing the infected joint replacement

AU - Love, Charito

AU - Pugliese, P. V.

AU - Afriyie, M. O.

AU - Tomas, M. B.

AU - Marwin, S. E.

AU - Palestro, C. J.

PY - 2000

Y1 - 2000

N2 - Purpose: F-18 FDG (FDG) is reportedly useful for detecting infection. Because the procedure is simple, with results being readily available, this prospective study was undertaken to evaluate the utility of FDG imaging for diagnosing infected joint replacements. Methods: 26 pts, 18 females and 4 males between 37 and 87 years old, with 31 joint replacements were studied. 21 pts had single joint replacement (10 hip, 11 knee); 5 pts had bilateral replacements (1 hip, 4 knee). Imaging was performed on a Hybrid PET system, with measured attenuation correction, one hour after administration of 150 MBq FDG. Increased peri-prosthetic uptake compared to adjacent, presumably normal, activity was interpreted as positive for infection. Results: 11 of 31 prostheses were infected. Sensitivity, specificity, and accuracy of FDG were 100%, 55%, and 71% respectively. The PPV was 55% and the NPV was 100%. Excluding the 5 asymptomatic prostheses in pts with bilateral joint replacements, the sensitivity, specificity, and accuracy were 100%, 47%, and 69% respectively. The PPV was 58% and the NPV was 100%. 4 pts with infected prostheses underwent a total of 6 follow-up studies after treatment. In 1 pt with persistent infection, all 3 follow-up studies were true positive. In the other 3 pts in whom infection had been eradicated, follow-up FDG studies were false positive. Conclusion: FDG imaging is sensitive but not specific; consequently, its role in pts with suspected prosthetic infection is limited to that of a screening test. These data also suggest that this technique is not useful for monitoring response to treatment.

AB - Purpose: F-18 FDG (FDG) is reportedly useful for detecting infection. Because the procedure is simple, with results being readily available, this prospective study was undertaken to evaluate the utility of FDG imaging for diagnosing infected joint replacements. Methods: 26 pts, 18 females and 4 males between 37 and 87 years old, with 31 joint replacements were studied. 21 pts had single joint replacement (10 hip, 11 knee); 5 pts had bilateral replacements (1 hip, 4 knee). Imaging was performed on a Hybrid PET system, with measured attenuation correction, one hour after administration of 150 MBq FDG. Increased peri-prosthetic uptake compared to adjacent, presumably normal, activity was interpreted as positive for infection. Results: 11 of 31 prostheses were infected. Sensitivity, specificity, and accuracy of FDG were 100%, 55%, and 71% respectively. The PPV was 55% and the NPV was 100%. Excluding the 5 asymptomatic prostheses in pts with bilateral joint replacements, the sensitivity, specificity, and accuracy were 100%, 47%, and 69% respectively. The PPV was 58% and the NPV was 100%. 4 pts with infected prostheses underwent a total of 6 follow-up studies after treatment. In 1 pt with persistent infection, all 3 follow-up studies were true positive. In the other 3 pts in whom infection had been eradicated, follow-up FDG studies were false positive. Conclusion: FDG imaging is sensitive but not specific; consequently, its role in pts with suspected prosthetic infection is limited to that of a screening test. These data also suggest that this technique is not useful for monitoring response to treatment.

UR - http://www.scopus.com/inward/record.url?scp=0000849710&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0000849710&partnerID=8YFLogxK

U2 - 10.1016/S1095-0397(00)00071-6

DO - 10.1016/S1095-0397(00)00071-6

M3 - Article

VL - 3

SP - 159

JO - Molecular Imaging and Biology

JF - Molecular Imaging and Biology

SN - 1536-1632

IS - 4

ER -