Visual Pattern and Serial Quantitation of 18F-Sodium Fluoride PET/CT in Asymptomatic Patients After Hip and Knee Arthroplasty

Son, Hye Joo; Jeong, Young Jin; Yoon, Hyun Jin; Wang, Lih; Kim, Hyeon Jun; Park, Jong‐Hwan

doi:10.1007/s13139-016-0430-0

Cited by 10 publications

(11 citation statements)

References 26 publications

(44 reference statements)

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“…The uptake patterns found in our study show some differences from those found in previous studies [4]. Our study describes a gradual increase in bone-forming activity for the first 7 days after surgery.…”

Section: Discussioncontrasting

confidence: 96%

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Natural Postoperative Bone Metabolic Changes after Total Knee Arthroplasty Determined by Positron Emission Tomography Scans

Kanetaka¹,

Kaneko²,

Wagatsuma³

et al. 2018

OJO

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Artificial joint replacement surgery is the orthopedic procedure of choice to relieve pain, correct joint deformities, and help patients resume everyday activities. However, the detailed mechanisms regulating peri-implant bone remodeling at the bone-prosthesis interface remain elusive. To address this gap in knowledge, we evaluated the natural postoperative course of bone metabolism by using [ 18 F] NaF positron emission tomography (PET)/computed tomography in 57 patients (104 joints) who underwent asymptomatic total knee arthroplasty (TKA). First, we measured total tracer uptake around TKA to determine the total bone metabolism (TBM) and used the ischial tuberosity as the reference tissue for normalization of PET images. Second, we calculated the TBM ratio (TBMR) by dividing the TBM by tracer uptake in the reference tissue. A moderate increase in TBMR was observed 4-5 days after implantation, and its intensity reached the maximum on the seventh postoperative day. The TBMR showed no differences until 12 weeks, after which it decreased slowly and returned to the basal levels. The new parameter TBMR and the unique pattern of postoperative metabolic changes in the bone around the prosthesis may help set accurate interpretation criteria to diagnose complications such as loosening or infections.

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Section: Discussioncontrasting

confidence: 96%

“…In 2016, Son et al [4] firstly reported the visual and quantitative analysis of [ 18 F] NaF uptake after joint replacement. In their study, however, the interval between the surgery and the scan was from 3 to 25 months; [ 18 F] NaF PET analysis was not performed within 3 months and after more than 25 months after the surgery.…”

Section: Introductionmentioning

confidence: 99%

Natural Postoperative Bone Metabolic Changes after Total Knee Arthroplasty Determined by Positron Emission Tomography Scans

Kanetaka¹,

Kaneko²,

Wagatsuma³

et al. 2018

OJO

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“…The criteria we used in our current study to differentiate non-specific uptake of 18 F-Fluoride from patterns specific for loosening are in close correlation with uptake patterns described by Son et al, who previously examined postoperative 18 F-Fluoride uptake in asymptomatic patients up to 25 months after hip or knee arthroplasty [21]. Our criteria for non-specific uptake correspond to areas of the bone interface which showed intense uptake in more than 75% of asymptomatic patients in the study by Son et al (Normal or no uptake see Figure 1 (A,D)) Specifically, these are the cranial and caudomedial parts of the acetabular component and the distal tip of the femoral component of hip prostheses.…”

Section: Methodssupporting

confidence: 54%

Diagnosis of peri-prosthetic loosening of total hip and knee arthroplasty using 18F-Fluoride PET/CT

et al. 2019

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Periprosthetic loosening, either aseptic or induced by periprosthetic joint infection remains a major long term complication and challenge in orthopedics and trauma surgery. Sensitivity of potential loosening of the material and other causes of a painful prosthesis is essential for choosing the respective treatment option and providing the needed resources. 18 F-Fluoride is a radiopharmaceutical which shows a high affinity to bone and a rapid blood clearance. The objective of this study was to assess 18 F-Fluoride PET/CT´s sensitivity and specificity in diagnosing periprosthetic loosening in total hip and knee arthroplasty. We included 26 patients with 24 hip and 13 knee prostheses in our retrospective study with radiological or clinical suspicion of peri-prosthetic loosening at least one year after implantation. Results of 18 F-Fluoride PET/CT imaging were compared with surgical results or clinical follow-up if surgery was not performed. On the basis of our data we found a sensitivity of 95.00 %, a specificity of 87.04 % and an accuracy of 89.19 % for 18 F-Fluoride PET/CT. The results of our study show that 18 F-Fluoride PET/CT is a useful and promising technique in diagnosing periprosthetic loosening of total hip and knee arthroplasties. Further investigation should focus on different uptake patterns of the isotope in periprosthetic joint infection and therefore distinguishing aseptic from septic loosening and enhancing the diagnostic value of this imaging method.

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“…Besides hip arthroplasty, NaF-PET has been used to image knee, ankle, and shoulder arthroplasties. [121][122][123][124][125] A study that included 24 hip and 13 knee prostheses found that NaF-PET/CT had a sensitivity of 95% and a specificity of 87% in diagnosing periprosthetic loosening (Fig. 4).…”

Section: Orthopedic Complicationsmentioning

confidence: 99%

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

et al. 2021

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The bone-seeking properties of 18 F-sodium fluoride (NaF) were first described in 1962 by Blau and colleagues, 1 who used this positron-emitting radiotracer in skeletal scintigraphy. Both high uptake by bone and rapid plasma clearance of NaF were determined to be advantages in imaging skeletal metabolism. 2 The mechanism of NaF uptake relies on the exchange of OH À for 18 F À , converting hydroxyapatite on the surface of the bone matrix to fluorapatite. 2,3 One hour after NaF is administered intravenously, only 10% remains in the plasma compartment because of a first-pass Conflict of interest: The authors have declared no conflicts of interest.

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Visual Pattern and Serial Quantitation of 18F-Sodium Fluoride PET/CT in Asymptomatic Patients After Hip and Knee Arthroplasty

Abstract: This is the first F-sodium fluoride PET/CT study investigating the stability of implants and sets a reference for evaluation of patients with complications.

Cited by 10 publications

References 26 publications

Natural Postoperative Bone Metabolic Changes after Total Knee Arthroplasty Determined by Positron Emission Tomography Scans

Natural Postoperative Bone Metabolic Changes after Total Knee Arthroplasty Determined by Positron Emission Tomography Scans

Diagnosis of peri-prosthetic loosening of total hip and knee arthroplasty using 18F-Fluoride PET/CT

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

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