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

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

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1043812

DOI=10.3389/fmed.2022.1043812

ISSN=2296-858X

ABSTRACT=<sec><title>Purpose</title><p>The aim of this study was to retrospectively analyze 18F-fluorodeoxyglucose (<sup>18</sup>F-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.</p></sec><sec><title>Methods</title><p><sup>18</sup>F-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<sub>max</sub>) were recorded and compared. Serologic data were also collected and the correlation between SUV<sub>max</sub> and serologic parameters was analyzed, while the images were classified based on the <sup>18</sup>F-FDG uptake pattern in the images using the diagnostic criteria proposed by Reinartz et al. (<xref ref-type="bibr" rid="B9">9</xref>). 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.</p></sec><sec><title>Results</title><p>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<sub>max</sub> and serologic results. The interobserver agreement between the two physicians in the classification according to the criteria of Reinartz et al. (<xref ref-type="bibr" rid="B9">9</xref>) was 0.957 (<italic>P</italic> &lt; 0.005). Although there was non-specific uptake in cases with an arthroplasty-to-PET/CT interval this was non-significant. Additionally, <sup>18</sup>F-FDG showed potential utility for dynamic observation of the condition of the hip.</p></sec><sec><title>Conclusion</title><p>SUV<sub>max</sub> provided information independent of serologic results, meanwhile <sup>18</sup>F-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 <sup>18</sup>F-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).</p></sec>