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Teiler J, Ahl M, Åkerlund B, et al. 99mTc-HMPAO-WBC SPECT/CT versus 18F-FDG-WBC PET/CT in chronic prosthetic joint infection: a pilot study. Nucl Med Commun. 2022;43(2):193-200doi: 10.1097/MNM.0000000000001502.
Teiler, J., Ahl, M., Åkerlund, B., Brismar, H., Holstensson, M., Gabrielson, S., Hedlund, H., & Axelsson, R. (2022). 99mTc-HMPAO-WBC SPECT/CT versus 18F-FDG-WBC PET/CT in chronic prosthetic joint infection: a pilot study. Nuclear medicine communications, 43(2), 193-200. https://doi.org/10.1097/MNM.0000000000001502
Teiler, Johan, et al. "99mTc-HMPAO-WBC SPECT/CT versus 18F-FDG-WBC PET/CT in chronic prosthetic joint infection: a pilot study." Nuclear medicine communications vol. 43,2 (2022): 193-200. doi: https://doi.org/10.1097/MNM.0000000000001502
Teiler J, Ahl M, Åkerlund B, Brismar H, Holstensson M, Gabrielson S, Hedlund H, Axelsson R. 99mTc-HMPAO-WBC SPECT/CT versus 18F-FDG-WBC PET/CT in chronic prosthetic joint infection: a pilot study. Nucl Med Commun. 2022 Feb 01;43(2):193-200. doi: 10.1097/MNM.0000000000001502. PMID: 34678830.
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Nucl Med Commun. 2022 Feb 01;43(2):193-200. doi: 10.1097/MNM.0000000000001502.

99mTc-HMPAO-WBC SPECT/CT versus 18F-FDG-WBC PET/CT in chronic prosthetic joint infection: a pilot study.

Nuclear medicine communications

Johan Teiler, Marcus Ahl, Börje Åkerlund, Harald Brismar, Maria Holstensson, Stefan Gabrielson, Håkan Hedlund, Rimma Axelsson

Affiliations

  1. Division of Radiology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm.
  2. Department of Radiology, Karolinska University Hospital, Huddinge.
  3. Department of Medicine Huddinge, Karolinska Institutet, Stockholm.
  4. Unit of Infectious Diseases, Karolinska University Hospital, Huddinge.
  5. Division of Orthopaedics and Biotechnology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm.
  6. Department of Orthopaedic Surgery, Karolinska University Hospital, Huddinge.
  7. Functional Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm.
  8. Function Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden.
  9. Radiology Service, Christchurch Hospital, Christchurch, New Zealand.
  10. Department of Orthopaedic Surgery, Visby Hospital, Visby, Sweden.

PMID: 34678830 DOI: 10.1097/MNM.0000000000001502

Abstract

PURPOSE: The aim of this study was to compare 99mTc-HMPAO-WBC-SPECT/CT combined with 99mTc-nanocollloid SPECT/CT and 18F-FDG-WBC-PET/CT combined with 99mTc-Nanocollloid SPECT/CT for the diagnosis and treatment evaluation of chronic prosthetic joint infection (PJI).

METHODS: Patients with suspected chronic PJI were examined with 99mTc-HMPAO-WBC SPECT/CT, 18F-FDG-WBC PET/CT, and 99mTc-nanocolloid SPECT/CT (to visualize bone marrow). The location and patterns of uptake were noted and compared between the two leukocyte examinations. Both leukocyte examinations were evaluated visually for infection. The PET examinations were also evaluated semiquantitatively. Chronic PJI was verified clinically by microbial culture and successfully treated PJI was confirmed by 12 months symptom-free follow-up after cessation of antibiotics.

RESULTS: Nineteen patients were included with 10 hip prostheses and nine knee prostheses. Fourteen were diagnosed with chronic PJI and five with successfully treated PJI. The sensitivity of visual evaluation of 99mTc-WBC-HMPAO SPECT/CT for all joints was 0.31 and for 18F-FDG-WBC PET/CT 0.38. The specificity was 0.80 and 0.83, respectively. All patients with a true-positive SPECT examination had a false-negative PET examination and vice versa. Semiquantitative evaluation of the hips gave an area under the curve of 0.905 using the iliac crest as the background. Semiquantitative evaluation of the knees did not produce significant results.

CONCLUSION: This pilot study showed no difference in the sensitivity or specificity of 99mTc-HMPAO-WBC SPECT/CT and 18F-FDG-WBC PET/CT when combined with 99mTc-nanocollloid SPECT/CT in the diagnosis or treatment evaluation of suspected late chronic PJI.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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