Die [F-18]-Fluorodeoxyglucose (FDG) Positronenemissionstomographie (PET) als Differenzialdiagnostikum der Hüftendoprothesenlockerung

Abstract

With a subtly differentiated interpretation (categories I - V) of the qualitative glucose metabolism safe statements can be made regarding septic/aseptic endoprostheses loosening. This was impressively confirmed by the agreement of the FDG results with the histological results.

Twenty‐three neutrophil granulocytes in 10 high‐power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening

“…[5][6][7] Various attempts have been made to optimize the pre-operative diagnostic procedure of infective loosening, [15][16][17] including time-consuming and expensive tests, such as fluorodeoxyglucose-positron emission tomography and immunoscintigraphy. 18,19 In contrast, histopathological examination is Figure 3. The receiver-operating characteristic curve (A) also shows that the neutrophilic granulocyte (NG) count has high sensitivity and specificity with respect to the clinical diagnosis, and the box plot (B; same annotation as in Figure 2B) demonstrates the distribution of the NG number (ordinate) depending on the clinical diagnosis (abscissa).…”

“…The timely and accurate diagnosis of periprosthetic infection has an important influence on consequent treatment in aspects of patient morbidity, hospitalization time and costs 5–7 . Various attempts have been made to optimize the pre‐operative diagnostic procedure of infective loosening, 15–17 including time‐consuming and expensive tests, such as fluorodeoxyglucose‐positron emission tomography and immunoscintigraphy 18,19 . In contrast, histopathological examination is comparatively inexpensive and has the additional ability to rule out malignancy and identify the type and amount of wear‐particles in cases of aseptic loosening.…”

Endoglin (CD105) expression differentiates between aseptic loosening and periprosthetic joint infection after total joint arthroplasty

“…The hypothesis of our study was that there is an increased vascularization in periprosthetic membranes during PJI in contrast to aseptic loosening of total hip or knee arthroplasty. As previous investigations proved increased vascularization in periprosthetic membranes via PET signals (Mumme et al 2003a , 2005 , 2003b ; Reinartz et al 2005 ; Kisielinski et al 2003 ), this study should create more understanding of both complications by investigating angiogenesis histologically and immunohistochemically. Guo et al ( 2006 ) describe a positive correlation between PET-signals and detection of endoglin-positive newly formed vessels in lung adenocarcinomas.…”

“…In this context, previous investigations revealed increased vascularization in periprosthetic membranes via PET signals (Mumme et al 2003a , 2005 , 2003b , Reinartz et al 2005 ; Kisielinski et al 2003 ). Concurrent, there is an intensive expression of endoglin (CD105) during angiogenesis, especially angioneogenesis in wound healing and inflammation (Torsney et al 2002 ).…”

Nuklearmedizinische Abklärung bei vermuteter Infektion einer Hüft- oder Knie-TEP

“…Grundlage ist der Transport des 18 [65]. Histopathologische Untersuchungen zeigten, dass neben bekannten Ursachen wie einer infektionsbedingten 18 F-FDG-Anreicherung auch die polyethylenabriebbedingte Fremdkörperreaktion als Ursache einer periprothetischen 18 F-FDG-Anreicherung aufzuführen ist [66][67][68][69][70]. Cremerius 18 F-FDG-PET; einen vergleichbaren Wert erzielte die Skelettszintigrafie.…”