2017 ISAKOS Biennial Congress ePoster #1288

 

Clinical Utility of Three Phase F-18 NaF Bone Pet for Evaluation of Infected Prosthesis - Preliminary Report

Kyung-Taek Kim, MD, PhD, Busan KOREA, REPUBLIC OF
Young Jin Jeong, MD, Busan KOREA, REPUBLIC OF
Lih Wang, MD, PhD, Busan KOREA, REPUBLIC OF

Dong-A University Medical Center, Busan, KOREA, REPUBLIC OF

FDA Status Not Applicable

Summary

Three Phase F-18 NaF Bone PET for Evaluation of Infected Prosthesis

Abstract

Purpose

Because F-18 NaF has a rapid kinetics than Tc-99m MDP, F-18 NaF bone PET has many advantages which are clear bone image, short imaging time and ability to quantify bone turn over. However, the usefulness of three phase NaF bone PET to diagnosis bone infection is not well known. In this study, we studied the clinical usefulness of three phase bone PET with F-18 NaF to identify the presence of prosthesis infection of joint.
Materials & Methods
Five patients who presented symptoms suggesting infection of joint prosthesis after joint replacement surgery of knee (n=4) or hip (n=1) were enrolled. All patients performed three phase Tc-99m MDP bone scan and F-18 NaF bone PET on the same day. Three patients performed 3-time point PET acquisition (perfusion, blood pool and delayed images). Other two patients underwent F-18 NaF bone PET examinations as following protocol. First, list mode image was obtained for 20 min after injection of F-18 NaF. The list mode data was reconstructed into dynamic curve for 20 min, perfusion and blood pool images. Second, delayed static bone phase scanning was performed at around 60 min after injection of radiotracer. Ten normal controls who underwent joint replace surgery without symptom were also recruited for. Three volume of interest were drawn on artery, muscle, bone marrow and two different site of bone in patients and normal control.

Results

Of five patients, infection of joint prosthesis was confirmed in 4 subjects. Non-infected joint prosthesis was revealed in another one patient and symptom of the patient gradually subsided with symptomatic treatment. As the patients with infected prosthesis, one patient without infection showed increased uptake in the peri-prosthesis area in delayed image. But pattern of tracer uptake was relatively even in patient with non-infected prosthesis. Time-activity curve for 20 min showed markedly different curve pattern between the patients with and without infected prosthesis.

Conclusion

This preliminary data suggested that F-18 NaF bone PET showed clearer three phase images which helped to identify the site and extent of disease. Adding of dynamic curve could improve diagnostic accuracy.