ArticleEuropean journal of nuclear medicine and molecular imaging2019
18F FDG-PET/CT has poor diagnostic accuracy in diagnosing shoulder PJI.
Article in European journal of nuclear medicine and molecular imaging, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 24 citations in OpenAlex.
- Plasma fibrinogen in the diagnosis of periprosthetic joint infection.Scientific reports · 2021Trial
- d-[5-ACS infectious diseases · 2025Article
- Value ofWorld journal of nuclear medicine · 2024Article
- HGT: A Hierarchical GCN-Based Transformer for Multimodal Periprosthetic Joint Infection Diagnosis Using Computed Tomography Images and Text.Sensors (Basel, Switzerland) · 2023Article
- A high prevalence of Cutibacterium acnes infections in scoliosis revision surgery, a diagnostic and therapeutic dilemma.Spine deformity · 2023Article
- Bone infection site targeting nanoparticle-antibiotics delivery vehicle to enhance treatment efficacy of orthopedic implant related infection.Bioactive materials · 2022Article
- Application ofBone & joint research · 2022Article
- A Systematic Review and Meta-Analysis on the Accuracy of Fluorodeoxyglucose Positron Emission Tomography/ Computerized Tomography for Diagnosing Periprosthetic Joint Infections.Frontiers in surgery · 2022Review
- Performance characteristics ofFrontiers in medicine · 2022Article
- Diagnosis of orthopaedic-implant-associated infections caused by slow-growing Gram-positive anaerobic bacteria - a clinical perspective.Journal of bone and joint infection · 2021Review
- Periprosthetic Infection After Reverse Shoulder Arthroplasty: a Review.Current reviews in musculoskeletal medicine · 2020Review
- The Role of Imaging Techniques to Define a Peri-Prosthetic Hip and Knee Joint Infection: Multidisciplinary Consensus Statements.Journal of clinical medicine · 2020Article
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10 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeChronic low-grade periprosthetic joint infection (PJI) of a shoulder replacement can be challenging to diagnose. 18F-FDG PET/CT is suggested as a modality to diagnose lower-limb PJI, but no studies on shoulder replacements exist. The aim of this study was therefore to determine the diagnostic accuracy of 18F-FDG PET/CT in diagnosing chronic PJI of the shoulder.
methodsPatients evaluated for a failed shoulder replacement during a 3-year period were prospectively included in the study. All patients underwent pre-operative 18F-FDG PET/CT, and were evaluated for signs of infection by three independent reviewers using shoulder-specific criteria. Interrater-agreement was calculated between the reviewers. If the patient had revision surgery, biopsy specimens were obtained and cultured with bacterial growth in the cultures serving as gold standard of infection.
resultsA total of 86 patients were included in the study. Nine patients were 18F-FDG PET/CT positive for infection, with only three true positive. Using the gold standard, infection was diagnosed after revision surgery in 22 cases. All infections were chronic and caused by low-virulent microbes. The sensitivity of 18F-FDG PET/CT was 0.14 95% CI (0.03-0.36), specificity 0.91 95% CI (0.81-0.97), positive predictive value was 0.40 95% CI (0.15-0.71) and negative predictive value 0.71 95% CI (0.67-0.75). The inter-observer agreement was 0.56 (Fleiss' kappa), indicating moderate agreement of the visual FDG-PET evaluation using the shoulder-specific criteria.
conclusion18F-FDG PET/CT has poor diagnostic accuracy in diagnosing low-grade PJI of the shoulder. 18F-FDG PET/CT cannot be recommended as a part of the routine preoperative workup to diagnose low-grade infection of a shoulder replacement.
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