Performance characteristics of 18F-fluorodeoxyglucose in non-infected hip replacement

Yiqun Wang; Lulu Yuan; Yinqiao Du; Honghong Liu; Qingxiao Li; Yan Chang; Yuanyuan Shi; Yanmei Wang; Xiaolin Meng; Yonggang Zhou; Shulin Yao; Jiahe Tian

doi:10.3389/fmed.2022.1043812

Performance characteristics of ¹⁸F-fluorodeoxyglucose in non-infected hip replacement

Front Med (Lausanne). 2023 Jan 5:9:1043812. doi: 10.3389/fmed.2022.1043812. eCollection 2022.

Authors

Yiqun Wang^{1

2}, Lulu Yuan¹, Yinqiao Du^{3

4}, Honghong Liu¹, Qingxiao Li¹, Yan Chang¹, Yuanyuan Shi², Yanmei Wang⁵, Xiaolin Meng¹, Yonggang Zhou^{3

4}, Shulin Yao¹, Jiahe Tian¹

Affiliations

¹ Department of Nuclear Medicine, The First Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
² Beijing Key Laboratory of Sports Injuries, Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China.
³ Department of Orthopedics Surgery, The First Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
⁴ Department of Orthopedics Surgery, The Fourth Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
⁵ General Electric (GE) Healthcare China, Shanghai, China.

Abstract

Purpose: The aim of this study was to retrospectively analyze 18F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/ computed tomography (CT) images of non-infected hip arthroplasty patients and summarize findings that may be useful for clinical practice.

Methods: ¹⁸F-FDG PET/CT images of non-infected hip arthroplasty patients were collected from September 2009 to August 2021. The region of interest was independently delineated by two physicians and maximum standardized uptake values (SUV_max) were recorded and compared. Serologic data were also collected and the correlation between SUV_max and serologic parameters was analyzed, while the images were classified based on the ¹⁸F-FDG uptake pattern in the images using the diagnostic criteria proposed by Reinartz et al. (9). The interval between hip replacement and PET/CT was classified by year and the characteristics of the two groups were compared. The images of patients who underwent PET/CT multiple times were analyzed dynamically.

Results: A total of 121 examinations were included; six patients underwent PET/CT twice and two patients had three scans. There were no significant correlations between SUV_max and serologic results. The interobserver agreement between the two physicians in the classification according to the criteria of Reinartz et al. (9) was 0.957 (P < 0.005). Although there was non-specific uptake in cases with an arthroplasty-to-PET/CT interval this was non-significant. Additionally, ¹⁸F-FDG showed potential utility for dynamic observation of the condition of the hip.

Conclusion: SUV_max provided information independent of serologic results, meanwhile ¹⁸F-FDG showed potential applicability to the dynamic monitoring of hip arthroplasty-related diseases. However, the presence of blood vessels and muscles affected image interpretation and the specificity of ¹⁸F-FDG was not optimal. A more specific radionuclide is needed to maximize the benefits of using PET/CT for the assessment of periprosthetic joint infection (PJI).

Keywords: 18F-FDG; PET/CT; arthroplasty; hip; image analysis.