FDG-PET Imaging in painful Hip Prosthesis

Summary

Principal Investigator: Abass Alavi
Affiliation: University of Pennsylvania
Country: USA
Abstract: Approximately 200,000 total hip replacements are performed in the U.S. each year. Although the incidence of acute infection following hip replacement is reduced as certain preventative measures have been adopted, both early and late infections remain as significant sources of morbidity, mortality and substantial expenses. The treatment of infected joint replacements has been estimated to cost between $50,000-60,000 per patient. Establishing the diagnosis of infection is quite difficult, and much of the morbidity and cost encountered is due to the lack of a single test that is highly accurate, and cost effective in the management of patients with painful total hip prosthesis. Current diagnostic tests including routine radiography, laboratory studies, and nuclear medicine procedures, suffer from significant shortcomings including accuracy and cost. It has been shown that [ 18-F] fluorine deoxyglucose (FDG) and Positron Emission Tomography (PET) reveal sites of inflammation with high sensitivity and specificity. In a pilot study conducted at our institution, we have been able to demonstrate that FDG-PET imaging has high accuracy in the setting of painful total hip prosthesis in a relatively small patient population. The main objective of the proposed research study is to determine the efficacy of FDG-PET imaging in the management of a painful total hip prosthesis in a large patient population. We also intend to compare FDG-PET imaging directly to conventional techniques including radio labeled white cell imaging for the diagnosis of hip infection to determine whether FDG-PET imaging is superior to the existing techniques. Furthermore, we will optimize the FDG-PET imaging criteria for diagnosing infection associated with hip prosthesis. We plan to enroll 530 patients over 5 years for the purposes outlined in the application. By implementing the proposed research, we will be able to demonstrate the effectiveness of this technique in the management of patients with painful hip arthroplasty. We believe this promising technology has great potential for the accurate diagnosis of this serious and challenging clinical problem, and may substantially influence the outcome in these patients.
Funding Period: 2002-09-27 - 2009-08-31
more information: NIH RePORT

Top Publications

  1. ncbi Critical role of 18F-labeled fluorodeoxyglucose PET in the management of patients with arthroplasty
    Hongming Zhuang
    Division of Nuclear Medicine, Department of Radiology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, 110 Donner Building, 3400 Spruce Street, Philadelphia, PA 19104, USA
    Radiol Clin North Am 45:711-8, vii. 2007
  2. pmc Role of modern imaging techniques for diagnosis of infection in the era of 18F-fluorodeoxyglucose positron emission tomography
    Rakesh Kumar
    Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
    Clin Microbiol Rev 21:209-24. 2008

Detail Information

Publications2

  1. ncbi Critical role of 18F-labeled fluorodeoxyglucose PET in the management of patients with arthroplasty
    Hongming Zhuang
    Division of Nuclear Medicine, Department of Radiology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, 110 Donner Building, 3400 Spruce Street, Philadelphia, PA 19104, USA
    Radiol Clin North Am 45:711-8, vii. 2007
    ..This review addresses the applications of FDG-PET in such clinical settings. In addition, the potential of PET in the assessing the viability of bone grafts in revision arthroplasty is discussed...
  2. pmc Role of modern imaging techniques for diagnosis of infection in the era of 18F-fluorodeoxyglucose positron emission tomography
    Rakesh Kumar
    Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
    Clin Microbiol Rev 21:209-24. 2008
    ..In the future, this modality is very likely to be employed on a routine basis for detecting, characterizing, and monitoring patients with suspected and proven infection...