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

Authors

  • 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

DOI:

https://doi.org/10.1080/17453674.2018.1525931

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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Published

2018-11-02

How to Cite

Gelderman, S. J., Jutte, P. C., Boellaard, R., Ploegmakers, J. J. W., Vállez García, D., Kampinga, G. A., Glaudemans, A. W. J. M., & Wouthuyzen-Bakker, M. (2018). 18F-FDG-PET uptake in non-infected total hip prostheses. Acta Orthopaedica, 89(6), 634–639. https://doi.org/10.1080/17453674.2018.1525931