Dataset Information

Occult Hip Prosthetic Loosening Diagnosed by [18F] Fluoride-PET/CT.

ABSTRACT:

Background

Positron emission tomography using the [18F] fluoride metabolite combined with computerized tomography (F-PET/CT) can be used to analyze the metabolic status of the periprosthetic bone after surgery for total hip arthroplasty.

Methods

To obtain normal PET referent values, 44 patients with 5 models of well-functioning hip prosthetic components were analyzed by F-PET/CT, radiography, and clinical score. Another group of patients having painful total hip arthroplasty, but whose radiography showed no conclusive signs of loosening, was analyzed by F-PET/CT scans before revision surgery.

Results

Preoperative median F-PET scores of the bone metabolic activity were 6.65 (3.3-9.0) for the painful stem group and 1.85 (1.2-3.9) (P < .01) for the referent group having the same stem model. At revision surgery, the stems in the painful group were assessed to be loose. At 2-year follow-up, the revised patients were all pain free.

Conclusion

F-PET/CT may be a new diagnostic tool for assessing occult loose stems that are not seen by radiography.

SUBMITTER: Ullmark G

PROVIDER: S-EPMC7397393 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Occult Hip Prosthetic Loosening Diagnosed by [18F] Fluoride-PET/CT.

Ullmark Gösta G

Arthroplasty today 20200801 3

<h4>Background</h4>Positron emission tomography using the [18F] fluoride metabolite combined with computerized tomography (F-PET/CT) can be used to analyze the metabolic status of the periprosthetic bone after surgery for total hip arthroplasty.<h4>Methods</h4>To obtain normal PET referent values, 44 patients with 5 models of well-functioning hip prosthetic components were analyzed by F-PET/CT, radiography, and clinical score. Another group of patients having painful total hip arthroplasty, but ...[more]

PMID: 32775585

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Project description:The purpose of this study was to compare the diagnostic performance of 18F-DCFBC PET/CT, a first-generation 18F-labeled prostate-specific membrane antigen (PSMA)-targeted agent, and 18F-NaF PET/CT, a sensitive marker of osteoblastic activity, in a prospective cohort of patients with metastatic prostate cancer. Methods: Twenty-eight prostate cancer patients with metastatic disease on conventional imaging prospectively received up to 4 PET/CT scans. All patients completed baseline 18F-DCFBC PET/CT and 18F-NaF PET/CT scans, and 23 patients completed follow-up imaging, with a median follow-up interval of 5.7 mo (range, 4.2-12.6 mo). Lesion detection was compared across the 2 PET/CT agents at each time point. Detection and SUV characteristics of each PET/CT agent were compared with serum prostate-specific antigen (PSA) levels and treatment status at the time of baseline imaging using nonparametric statistical testing (Spearman correlation, Wilcoxon rank). Results: Twenty-six patients had metastatic disease detected on 18F-NaF or 18F-DCFBC at baseline, and 2 patients were negative on both scans. Three patients demonstrated soft tissue-only disease. Of 241 lesions detected at baseline, 56 were soft-tissue lesions identified by 18F-DCFBC only and 185 bone lesions detected on 18F-NaF or 18F-DCFBC. 18F-NaF detected significantly more bone lesions than 18F-DCFBC (P < 0.001). Correlation of PSA with patient-level SUV metrics was strong in 18F-DCFBC (ρ > 0.5, P < 0.01) and poor in 18F-NaF (ρ < 0.3, P > 0.1). When PSA levels were combined with treatment status, patients with below-median levels of PSA (<2 ng/mL) on androgen deprivation therapy (n = 11) demonstrated more lesions on 18F-NaF than 18F-DCFBC (P = 0.02). In PSA greater than 2 ng/mL, patients on androgen deprivation therapy (n = 8) showed equal to or more lesions on 18F-DCFBC than on 18F-NaF. Conclusion: The utility of PSMA-targeting imaging in metastatic prostate cancer appears to depend on patient disease course and treatment status. Compared with 18F-NaF PET/CT, 18F-DCFBC PET/CT detected significantly fewer bone lesions in the setting of early or metastatic castrate-sensitive disease on treatment. However, in advanced metastatic castrate-resistant prostate cancer, 18F-DCFBC PET/CT shows good concordance with NaF PET/CT.

Project description:AimsDiagnosis of prosthetic valve endocarditis (PVE) by positron emission computed tomography angiography (PET/CTA) is based on visual and quantitative morpho-metabolic features. However, the fluorodeoxyglucose (FDG) uptake pattern can be sometimes visually unclear and susceptible to subjectivity. This study aimed to validate a new parameter, the valve uptake index [VUI, maximum standardized uptake value (SUVmax)-mean standardized uptake value (SUVmean)/SUVmax], designed to provide a more objective indication of the distribution of metabolic activity. Secondly, to re-evaluate the utility of traditionally used PVE imaging criteria and determine the potential value of adding the VUI in the diagnostic algorithm of PVE.Methods and resultsRetrospective analysis of 122 patients (135 prosthetic valves) admitted for suspicion of endocarditis, with a conclusive diagnosis of definite (N = 57) or rejected (N = 65) PVE, and who had undergone a cardiac PET/CTA scan as part of the diagnostic evaluation. We measured the VUI and recorded the SUVmax, SUVratio, uptake pattern, and the presence of endocarditis-related anatomic lesions. The VUI, SUVmax, and SUVratio values were 0.54 ± 0.1 vs. 0.36 ± 0.08, 7.68 ± 3.07 vs. 3.72 ± 1.11, and 4.28 ± 1.93 vs. 2.16 ± 0.95 in the 'definite' PVE group vs. the 'rejected' group, respectively (mean ± SD; P < 0.001). A cut-off value of VUI > 0.45 showed a sensitivity, specificity, and diagnostic accuracy for PVE of 85%, 88%, and 86.7% and increased diagnostic ability for confirming endocarditis when combined with the standard diagnostic criteria.ConclusionsThe VUI demonstrated good diagnostic accuracy for PVE, even increasing the diagnostic power of the traditionally used morphometabolic parameters, which also confirmed their own diagnostic performance. More research is needed to assess whether the integration of the VUI into the PVE diagnostic algorithm may clarify doubtful cases and thus improve the diagnostic yield of PET/CTA.

Dataset Information

Occult Hip Prosthetic Loosening Diagnosed by [18F] Fluoride-PET/CT.

Background

Methods

Results

Conclusion

Publications

Occult Hip Prosthetic Loosening Diagnosed by [18F] Fluoride-PET/CT.

Similar Datasets

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