FDG-PET may become a "routine clinical tool" for the diagnosis of prosthetic joint infection, researchers say.

FDG-PET may become a "routine clinical tool" for the diagnosis of prosthetic joint infection, researchers say [1].

The diagnosis of prosthetic joint infection can be difficult. While combined leucocyte scintigraphy is often viewed as the imaging modality of choice, availability is limited. Meanwhile, artifacts produced by prosthetic devices can complicate CT and MRI image interpretation.

A meta-analysis looking at FDG-PET in this setting, which involved 11 studies and 635 hip and knee prostheses, reported a pooled sensitivity and specificity of 82.1 per cent and 86.6 per cent, respectively. In all studies, a combination of tests served as the reference standard.

The authors said of their findings: "Overall diagnostic performance of FDG-PET was moderate to high. Caution is warranted, however, because results of individual studies were heterogeneous and could not be fully explored."

Dr Thomas Kwee, a radiologist from the University Medical Center Utrecht in the Netherlands and one of the study authors, said that identifying prosthetic joint infection was "of crucial importance."

"The number of patients with infected joint prostheses is expected to increase, since the number of annually performed arthroplasties in the Western world is rising every year and the population is aging. Thus, the availability of a reliable diagnostic tool is and will only become more and more important."

He summated: "An important issue is to identify factors that might influence the diagnostic performance of FDG-PET. Certainly, more research is needed, but FDG-PET is expected to become a routine clinical tool for diagnosing prosthetic joint infection."

[1] FDG-PET for diagnosing prosthetic joint infection: systematic review and metaanalysis
Eur J Nucl Med Mol Imaging 2008; Online first

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