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

Stefan J Gelderman, Paul C Jutte, Ronald Boellaard, Joris J W Ploegmakers, David Vállez García, Greetje A Kampinga, Andor W J M Glaudemans, Marjan Wouthuyzen-Bakker

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and purpose - 18F-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 (rs = 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.

LanguageEnglish
Pages1-6
Number of pages6
JournalActa Orthopaedica
DOIs
StateE-pub ahead of print - 18 Oct 2018

Cite this

Gelderman, S. J., Jutte, P. C., Boellaard, R., Ploegmakers, J. J. W., Vállez García, D., Kampinga, G. A., ... Wouthuyzen-Bakker, M. (2018). 18F-FDG-PET uptake in non-infected total hip prostheses. Acta Orthopaedica, 1-6. DOI: 10.1080/17453674.2018.1525931
Gelderman, Stefan J ; Jutte, Paul C ; Boellaard, Ronald ; Ploegmakers, Joris J W ; Vállez García, David ; Kampinga, Greetje A ; Glaudemans, Andor W J M ; Wouthuyzen-Bakker, Marjan. / 18F-FDG-PET uptake in non-infected total hip prostheses. In: Acta Orthopaedica. 2018 ; pp. 1-6
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title = "18F-FDG-PET uptake in non-infected total hip prostheses",
abstract = "Background and purpose - 18F-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 (rs = 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.",
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Gelderman, SJ, Jutte, PC, Boellaard, R, Ploegmakers, JJW, Vállez García, D, Kampinga, GA, Glaudemans, AWJM & Wouthuyzen-Bakker, M 2018, '18F-FDG-PET uptake in non-infected total hip prostheses' Acta Orthopaedica, pp. 1-6. DOI: 10.1080/17453674.2018.1525931

18F-FDG-PET uptake in non-infected total hip prostheses. / Gelderman, Stefan J; Jutte, Paul C; Boellaard, Ronald; Ploegmakers, Joris J W; Vállez García, David; Kampinga, Greetje A; Glaudemans, Andor W J M; Wouthuyzen-Bakker, Marjan.

In: Acta Orthopaedica, 18.10.2018, p. 1-6.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Gelderman,Stefan J

AU - Jutte,Paul C

AU - Boellaard,Ronald

AU - Ploegmakers,Joris J W

AU - Vállez García,David

AU - Kampinga,Greetje A

AU - Glaudemans,Andor W J M

AU - Wouthuyzen-Bakker,Marjan

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Y1 - 2018/10/18

N2 - Background and purpose - 18F-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 (rs = 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.

AB - Background and purpose - 18F-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 (rs = 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.

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DO - 10.1080/17453674.2018.1525931

M3 - Article

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JO - Acta Orthopaedica

T2 - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

ER -

Gelderman SJ, Jutte PC, Boellaard R, Ploegmakers JJW, Vállez García D, Kampinga GA et al. 18F-FDG-PET uptake in non-infected total hip prostheses. Acta Orthopaedica. 2018 Oct 18;1-6. Available from, DOI: 10.1080/17453674.2018.1525931