title: Technetium-99m-labeled annexin V imaging for detecting prosthetic joint infection in a rabbit model.
abstract: Accurate and timely diagnosis of prosthetic joint infection is essential to initiate early treatment and achieve a favorable outcome. In this study, we used a rabbit model to assess the feasibility of technetium-99m-labeled annexin V for detecting prosthetic joint infection. Right knee arthroplasty was performed on 24 New Zealand rabbits. After surgery, methicillin-susceptible Staphylococcus aureus was intra-articularly injected to create a model of prosthetic joint infection (the infected group, n = 12). Rabbits in the control group were injected with sterile saline (n = 12). Seven and 21 days after surgery, technetium-99m-labeled annexin V imaging was performed in 6 rabbits of each group. Images were acquired 1 and 4 hours after injection of technetium-99m-labeled annexin V (150 MBq). The operated-to-normal-knee activity ratios were calculated for quantitative analysis. Seven days after surgery, increased technetium-99m-labeled annexin V uptake was observed in all cases. However, at 21 days a notable decrease was found in the control group, but not in the infected group. The operated-to-normal-knee activity ratios of the infected group were 1.84 ± 0.29 in the early phase and 2.19 ± 0.34 in the delay phase, both of which were significantly higher than those of the control group (P = 0.03 and P = 0.02). The receiver operator characteristic curve analysis showed that the operated-to-normal-knee activity ratios of the delay phase at 21 days was the best indicator, with an accuracy of 80%. In conclusion, technetium-99m-labeled annexin V imaging could effectively distinguish an infected prosthetic joint from an uninfected prosthetic joint in a rabbit model.
authors.affiliation: Department of Orthopedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Tang
authors.affiliation: Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, the First Affiliated Hospital of Shanxi Medical University, Taiyuan 030001, China.
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210006, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Lu
authors.affiliation: Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Tian
authors.affiliation: Department of Orthopedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Orthopedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
authors.forename: Chengzhe
authors.initials: C
authors.lastname: Jin
authors.affiliation: Department of Orthopedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Wang
keywords: annexin V; diagnosis; prosthetic joint infection; technetium-99m