title: Leukocyte and bacteria imaging in prosthetic joint infection.
abstract: There has been a significant increase in the number of joint prosthesis replacements worldwide. Although relatively uncommon, complications can occur with the most serious being an infection. Various radiological and nuclear imaging techniques are available to diagnose prosthetic joint infections (PJI). In this review article, we describe the pathophysiology of PJI, the principles of nuclear medicine imaging and the differences between Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET). The value of nuclear medicine techniques for clinical practice is also discussed. Then we provide an overview of the most often used radionuclide imaging techniques that may be helpful in diagnosing prosthetic joint infection: the (67)Ga-citrate, labelled white blood cells in vitro and in vivo (monoclonal antibodies directed against specific targets on the leukocytes), and (18)F-fluorodeoxyglucose ((18)F-FDG). We describe their working methods, the pitfalls, and the interpretation criteria. Furthermore, we review recent advances in imaging bacteria, a molecular imaging method that holds promises for the detection of occult infections. We conclude proposing two diagnostic flow-charts, based on data in the literature, that could help the clinicians to choose the best nuclear imaging method when they have a patient with suspicion of or with proven PJI.
authors: Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors: Andor W J M
authors: AW
authors: Glaudemans
authors: Filippo
authors: F
authors: Galli
authors: Marta
authors: M
authors: Pacilio
authors: Alberto
authors: A
authors: Signore
mesh_terms: D001424:Bacterial Infections / Q000000981:diagnostic imaging* / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D005710:Gallium Radioisotopes; D006801:Humans; D007595:Joint Prosthesis / Q000382:microbiology; D007962:Leukocytes / Q000000981:diagnostic imaging / Q000473:pathology*; D049268:Positron-Emission Tomography; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D019275:Radiopharmaceuticals; D013194:Staining and Labeling; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013667:Technetium