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General Clinical Specialties: Infectious Disease/HematologyInfectious Disease/Hematology Posters |
1 Nuclear Medicine, IRCCS MultiMedica, Sesto San Giovanni (MI), Italy
1137
Objectives: Painful prosthesis is a common but aspecific symptom after joint replacement. The accurate diagnosis is often difficult. Aim of this study was to evaluate the diagnostic efficacy of antigranulocyte scintigraphy (AS) with 99mTc-sulesomab and PET with FDG in the diagnosis of prosthesis infection in subjects with total hip or knee arthroplasty.
Methods: 21 patients (8 M; 13 F; mean age 70 years) with suspected total joint arthroplasty infection (7 hip; 14 knee) underwent examination with AS and subsequent PET. All patients had a complete operative and/or clinical follow up. Clinical classification: 0-normal; 1- phlogosis; 2-infection; AS and PET were evaluated by visual analysis using the same score. SUV values were considered on PET.
Results: 6 patients were clinically negative; 8 had aseptic phlogosis; 7 had infection. The overall sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were 87%, 83%, 93%, 71% and 85% respectively for AS and 93%; 67%; 88%; 80% and 85% for PET. In the differentiation between phlogosys and infection, PET showed a sensitivity, specificity and accuracy respectively of 93%, 57% e 81%; AS results were 71%, 71, % and 71%. SUV didn’t show a significant correlation with the degree of arthroplasty complication.
Conclusions: AS and PET had a high discriminating value for the detection of prosthesis infection; particularly PET had a great sensitivity and AS the best specificity. Our study suggests that PET is more useful in the evaluation of joint pain after arthroplasty while AS is preferable in clinical suspect of infection.
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