Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 28;5(1):4.
doi: 10.1186/s41824-021-00098-y.

Diagnostic accuracy of SPECT/CT arthrography in patients with suspected aseptic joint prostheses loosening

Bo Bao  1 , Crystal S Liu  2 , Edward C O Masson  3 , Jonathan T Abele  4
Affiliations

Diagnostic accuracy of SPECT/CT arthrography in patients with suspected aseptic joint prostheses loosening

Bo Bao et al. Eur J Hybrid Imaging. .

Abstract

Purpose: To evaluate the diagnostic accuracy of SPECT/CT arthrography in patients with suspected aseptic prosthesis loosening following hip and knee arthroplasty.

Methods: A retrospective review of 63 SPECT/CT arthrogram studies (36 knees and 27 hips) between February 1, 2013, and July 1, 2018, was conducted. All patients underwent clinical and radiologic evaluation as part of their assessment for persistent pain following hip and knee arthroplasty. The detection of tracer activity along the bone-prosthetic interface on SPECT/CT suggests aseptic loosening. Operative assessment as well as clinical/radiologic follow-up at a minimum of 1 year was used as the reference standard.

Results: The sensitivity and specificity of SPECT/CT for detection of aseptic loosening was 6/7 (86%) and 55/56 (98%), respectively. This gives a positive predictive value (PPV) of 6/7 (86%), a negative predictive value (NPV) of 55/56 (98%), and a diagnostic accuracy of 61/63 (97%).

Conclusion: SPECT/CT arthrography has a high diagnostic accuracy (97%) in the evaluation of loosening of both hip and knee arthroplasties in patients with persistent post-procedural pain.

Keywords: Loosening; SPECT/CT; Total hip arthroplasty; Total knee arthroplasty.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study participants. TP, true positive; TN, true negative; FP, false positive; FN, false negative
Fig. 2
Fig. 2
Normal left knee total arthroplasty. Sagittal (left) and coronal (right) imaging with CT (top row) and fused SPECT/CT (bottom row) images showing normal tracer activity within the joint space
Fig. 3
Fig. 3
Tibial component loosening of a left knee total arthroplasty. The radiograph images demonstrate no evidence of loosening (first column). Coronal (top) and sagittal CT (second column), SPECT (third column), and fused SPECT/CT (fourth column) images showing abnormal tracer activity along the bone-prosthetic interface of the tibial component
Fig. 4
Fig. 4
Femoral component loosening of a right hip total arthroplasty. The radiograph images demonstrate lucency along the metal-bone interface (first column). Coronal (top) and sagittal CT (second column), SPECT (third column), and fused SPECT/CT (fourth column) images showing abnormal tracer activity along the bone-prosthetic interface of the femoral component
See this image and copyright information in PMC

References

    1. Abele JT, Swami VG, Russell G, Masson EC, Flemming JP. The accuracy of single photon emission computed tomography/computed tomography arthrography in evaluating aseptic loosening of hip and knee prostheses. J Arthroplast. 2015;30(9):1647–1651. doi: 10.1016/j.arth.2015.03.033. - DOI - PubMed
    1. Abu-Amer Y, Darwech I, Clohisy JC. Aseptic loosening of total joint replacements: mechanisms underlying osteolysis and potential therapies. Arthritis Res Ther. 2007;9(Suppl 1):S6. doi: 10.1186/ar2170. - DOI - PMC - PubMed
    1. Barnsley L, Barnsley L. Detection of aseptic loosening in total knee replacements: a systematic review and meta-analysis. Skelet Radiol. 2019;48(10):1565–1572. doi: 10.1007/s00256-019-03215-y. - DOI - PubMed
    1. Becker R, Bonnin M, Hofmann S. The painful knee after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011;19(9):1409–1410. doi: 10.1007/s00167-011-1625-7. - DOI - PubMed
    1. Claassen L, Ettinger M, Plaass C, Daniilidis K, Calliess T, Ezechieli M. Diagnostic value of bone scintigraphy for aseptic loosening after total knee arthroplasty. Technol Health Care. 2014;22(5):767–773. doi: 10.3233/THC-140850. - DOI - PubMed

LinkOut - more resources