title: Comparison of fluorodeoxyglucose positron emission tomography and (111)indium-white blood cell imaging in the diagnosis of periprosthetic infection of the hip.
abstract: We aimed to compare the accuracy of fluorodeoxyglucose positron emission tomography (FDG-PET) with technetium-99m sulfur colloid (111)indium-labeled white blood cell scintigraphy (TcSC-Ind BM/WBC) in diagnosis of periprosthetic infection. Eighty-nine patients with 92 painful hip prostheses were recruited prospectively and given the option of undergoing either combined FDG-PET and TcSC-Ind BM/WBC or FDG-PET only. FDG-PET correctly diagnosed 20 of the 21 infected cases (sensitivity, 95.2%) and ruled out infection in 66 of the 71 aseptic hips (specificity, 93%) corresponding to a positive predictive value of 80% (20/25) and a negative predictive value of 98.5% (66/67). TcSC-Ind BM/WBC correctly identified 5 of the 10 infected cases (sensitivity, 50%) and 39 of 41 aseptic cases (specificity, 95.1%) corresponding to a positive and negative predictive values of 41.7% (5/12 cases) and 88.6% (39/44 cases), respectively. Based on these preliminary results, FDG-PET appears to be a promising diagnostic tool for distinguishing septic from aseptic painful hip prostheses.
authors.affiliation: Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Pill
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Peter H
authors.initials: PH
authors.lastname: Tang
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Garino
authors.forename: Charles
authors.initials: C
authors.lastname: Nelson
authors.forename: Hongming
authors.initials: H
authors.lastname: Zhuang
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D019544:Equipment Failure Analysis / Q000379:methods; D006801:Humans; D007204:Indium; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010147:Pain Measurement; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012086:Reoperation; D012680:Sensitivity and Specificity; D013671:Technetium Tc 99m Sulfur Colloid
chemical_list: D015415:Biomarkers; D019275:Radiopharmaceuticals; D007204:Indium; C020758:indium trichloride; D013671:Technetium Tc 99m Sulfur Colloid