Evidence map›Paper›PMID 31642691›Full record

ArticleThe British journal of radiology2020

Magnetic resonance imaging (MRI) versus single photon emission computed tomography (SPECT/CT) in painful total hip arthroplasty: a comparative multi-institutional analysis.

Henrik C Bäcker, Isabelle Steurer-Dober, Martin Beck, Christoph A Agten, Jens Decking, Richard F Herzog, Jeffrey A Geller, Ujwal Bhure, Justus E Roos, Klaus Strobel

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Review
  6. The Role of Nuclear Medicine Imaging withDiagnostics (Basel, Switzerland) · 2022
    Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Henrik C BäckerRadiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.ORCID http://orcid.org/0000-0002-4265-477X
Isabelle Steurer-DoberRadiology, Cantonal Hospital Zug, Baar, Switzerland.
Martin BeckOrthopedic Surgery and Traumatology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Christoph A AgtenRadiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Jens DeckingOrthopedic Surgery, Cantonal Hospital Lucerne, Sursee, Switzerland.
Richard F HerzogOrthopedic Surgery, Cantonal Hospital Lucerne, Wolhusen, Switzerland.
Jeffrey A GellerDepartment of Orthopedic Surgery, Columbia University Medical Center/ Presbyterian Hospital, New York, United States.
Ujwal BhureRadiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Justus E RoosRadiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Klaus StrobelRadiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the value of MRI in comparison to single photon emission computed tomography (SPECT)/CT in patients with painful hip arthroplasties.

methodsA prospective, multi-institutional study was performed. Therefore, 35 consecutive patients (21 female, 14 male, mean age 61.8 ± 13.3 years) with 37-painful hip arthroplasties were included. A hip surgeon noted the most likely diagnosis based on clinical examination and hip radiographs. Then, MRI and SPECT/CT of the painful hips were acquired. MRI and SPECT/CT were assessed for loosening, infection, fracture, tendon pathology and other abnormalities. Final diagnosis and therapy was established by the hip surgeon after integration of MRI and SPECT/CT results. The value of MRI and SPECT/CT for diagnosis was assessed with a 3-point scale (1 = unimportant, 2 = helpful, 3 = essential).

resultsLoosening was observed in 13/37 arthroplasties (6 shaft only, 6 cup only, 1 combined). Sensitivity, specificity, positive predictive value and negative predictive value for loosening of MRI were 86%/88%/60%/100% and of SPECT/CT 93%/97%/90%/100%, respectively. MRI and SPECT/CT diagnosed infection correctly in two of three patients and fractures in two patients, which were missed by X-ray. MRI detected soft tissue abnormalities in 21 patients (6 bursitis, 14 tendon lesions, 1 pseudotumor), of which only 1 tendon abnormality was accurately detected with SPECT/CT. All 5 arthroplasties with polyethylene wear were correctly diagnosed clinically and with both imaging modalities. MRI and SPECT/CT were judged as not helpful in 0/0%, as helpful in 16%/49% and essential in 84%/51%.

conclusionIn patients with painful hip arthroplasty SPECT/CT is slightly superior to MR in the assessment of loosening. MRI is far superior in the detection of soft tissue, especially tendon pathologies. ADVANCES IN KNOWLEDGE: To our knowledge this is the first prospective, multiinstitutional study which compares MRI with SPECT/CT in painful hip arthroplasties. We found that MRI is far superior in the detection of soft tissue pathologies, whereas SPECT/CT remains slightly superior regarding loosening.

Indexed as

Arthroplasty, Replacement, HipFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedPain MeasurementPostoperative PainPredictive Value of TestsProsthesis FailureProsthesis-Related InfectionsSensitivity and SpecificityTomography, Emission-Computed, Single-Photon

Identifiers

PMID31642691
PMCPMC6948088

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.