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Stellenwert der SPECT/CT bei Knie- und Hüftgelenkprothesen

Importance of SPECT/CT for knee and hip joint Prostheses

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Zusammenfassung

Klinisches/methodisches Problem

Komplikationen wie Lockerung und Infekt stellen ein häufiges Problem nach Hüft- und Kniegelenkprothesen dar.

Radiologische Standardverfahren

Wenn die konventionelle Röntgenaufnahme nicht zum Ziel führt, ist die klassische konventionelle Skelettszintigraphie die am häufigsten verwendete „Second-line“-Bildgebung.

Methodische Innovationen

Die „single photon emission computed tomography“/CT (SPECT/CT) bietet metabolische und morphologische Informationen bzgl. Prothesenkomplikationen in einem Untersuchungsgang und ist zunehmend in größeren Kliniken verfügbar.

Leistungsfähigkeit

Die SPECT/CT ist eine viel versprechende Methode und wird im klinischen Alltag bei der Evaluation von Gelenkprothesen zunehmend eingesetzt. Es sind noch mehr prospektive Studien nötig, um die Leistungsfähigkeit und den Zusatznutzen gegenüber der klassischen Szintigraphie zu evaluieren.

Bewertung

In unserer Klinik wird die Knochenszintigraphie bei der Abklärung von Prothesenkomplikationen zumeist mit einer SPECT/CT kombiniert und liefert regelmäßig wichtige Zusatzinformationen.

Empfehlung für die Praxis

Die SPECT/CT entwickelt sich zunehmend zum Standard der „Second-line“-Abklärung von Gelenkprothesen nach dem konventionellen Röntgenbild.

Abstract

Clinical/methodical issue

Complications, such as loosening or infections are common problems after hip or knee arthroplasty.

Standard radiological methods

If conventional X-rays are equivocal bone scintigraphy is the classical second-line imaging modality.

Methodical innovations

Single photon emission computed tomography/computed tomography (SPECT/CT) offers metabolic and morphologic information in one imaging step and is becoming increasingly more available in larger hospitals.

Performance

The SPECT/CT procedure is a promising method and is increasingly being used in daily routine to evaluate joint arthroplasty. The additional benefit compared with classical conventional bone scintigraphy has to be evaluated in further prospective studies.

Achievements

In our hospital SPECT/CT regularly gives important additional information regarding prosthetic joint complications.

Practical recommendations

SPECT/CT is increasingly being used as the second step imaging standard modality if conventional X-rays are equivocal.

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Literatur

  1. Ahmad R, Kumar GS, Katam K et al (2009) Significance of a „hot patella“ in total knee replacement without primary patellar resurfacing. Knee 16:337–340

    Article  PubMed  CAS  Google Scholar 

  2. Aliabadi P, Tumeh SS, Weissman BN et al (1989) Cemented total hip prosthesis: radiographic and scintigraphic evaluation. Radiology 173:203–206

    PubMed  CAS  Google Scholar 

  3. Berger RA, Crossett LS, Jacobs JJ et al (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153

    Article  PubMed  Google Scholar 

  4. Berquist TH (2006) Imaging of joint replacement procedures. Radiol Clin North Am 44:419–437

    Article  PubMed  Google Scholar 

  5. Berry DJ, Harmsen WS, Cabanela ME et al (2002) Twenty-five-year survivorship of two thousand consecutive primary Charnley total hip replacements: factors affecting survivorship of acetabular and femoral components. J Bone Joint Surg [Am] 84-A:171–177

  6. Bunyaviroch T, Aggarwal A, Oates ME (2006) Optimized scintigraphic evaluation of infection and inflammation: role of single-photon emission computed tomography/computed tomography fusion imaging. Semin Nucl Med 36:295–311

    Article  PubMed  Google Scholar 

  7. Callaghan JJ, Van Nostrand D, Dysart SH et al (1996) Prospective serial technetium diphosphonate and indium-111 white blood cell labeled imaging in primary uncemented total hip arthroplasty. Iowa Orthop J 16:104–112

    PubMed  CAS  Google Scholar 

  8. Filippi L, Schillaci O (2006) Usefulness of hybrid SPECT/CT in 99mTc-HMPAO-labeled leukocyte scintigraphy for bone and joint infections. J Nucl Med 47:1908–1913

    PubMed  CAS  Google Scholar 

  9. Gelman MI, Coleman RE, Stevens PM et al (1978) Radiography, radionuclide imaging, and arthrography in the evaluation of total hip and knee replacement. Radiology 128:677–682

    PubMed  CAS  Google Scholar 

  10. Gemmel F, Van Den Wyngaert H, Love C et al (2012) Prosthetic joint infections: radionuclide state-of-the-art imaging. Eur J Nucl Med Mol Imaging 39:892–909

    Article  PubMed  CAS  Google Scholar 

  11. Gill GS, Chan KC, Mills DM (1997) Five- to eighteen-year follow-up study of cemented total knee arthroplasty for patients 55 years old or younger. J Arthroplasty 12:49–54

    Article  PubMed  CAS  Google Scholar 

  12. Gill GS, Joshi AB, Mills DM (1999) Total condylar knee arthroplasty. Sixteen- to twenty-one-year results. Clin Orthop Relat Res 367:210–215

    Article  PubMed  Google Scholar 

  13. Graute V, Feist M, Lehner S et al (2012) Detection of low-grade prosthetic joint infections using 99 mTc-antigranulocyte SPECT/CT: initial clinical results. Eur J Nucl Med Mol Imaging 37:1751–1759

    Article  Google Scholar 

  14. Hayter Cl, Koff MF, Shah P et al (2012) MRI after arthroplasty: comparison of MAVRIC and conventional fast spin-echo techniques. AJR Am J Roentgenol 197:W405–W411

    Article  Google Scholar 

  15. Hirschmann MT, Iranpour F, Konala P et al (2012) A novel standardized algorithm for evaluating patients with painful total knee arthroplasty using combined single photon emission tomography and conventional computerized tomography. Knee Surg Sports Traumatol Arthrosc 18:939–944

    Article  Google Scholar 

  16. Hirschmann MT, Konala P, Iranpour F et al (2012) Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty – a new dimension of diagnostics? BMC Musculoskelet Disord 12:36

    Article  Google Scholar 

  17. Moilanen T, Scott G, Newell M et al (1997) Bone scintigraphic appearance of asymptomatic hydroxyapatite-coated hip arthroplasties. J Arthroplasty 12:380–386

    Article  PubMed  CAS  Google Scholar 

  18. Pfirrmann CW, Notzli HP, Dora C et al (2005) Abductor tendons and muscles assessed at MR imaging after total hip arthroplasty in asymptomatic and symptomatic patients. Radiology 235:969–976

    Article  PubMed  Google Scholar 

  19. Romer W, Olk A, Hennig FF et al (2005) Assessment of aseptic loosening of the acetabular component in a total hip replacement with 99mTc-DPD-SPECT/spiral-CT hybrid imaging. Nuklearmedizin 44:N58–N60

    PubMed  CAS  Google Scholar 

  20. Rosenthall L, Lepanto L, Raymond F (1987) Radiophosphate uptake in asymptomatic knee arthroplasty. J Nucl Med 28:1546–1549

    PubMed  CAS  Google Scholar 

  21. Rubello D, Caricasulo D, Borsato N et al (1996) Three-phase bone scan pattern in asymptomatic uncemented total knee arthroplasty. Eur J Nucl Med 23:1400–1403

    Article  PubMed  CAS  Google Scholar 

  22. Sacchetti GM, Ghisellini F, Brambilla M et al (1996) Quantitative scintigraphic evaluation of total knee arthroplasties: a feasibility study. Clin Orthop Relat Res 325:181–189

    Article  PubMed  Google Scholar 

  23. Schillaci O (2009) Hybrid imaging systems in the diagnosis of osteomyelitis and prosthetic joint infection. Q J Nucl Med Mol Imaging 53:95–104

    PubMed  CAS  Google Scholar 

  24. Shehab D, Elgazzar AH, Collier BD (2002) Heterotopic ossification. J Nucl Med 43:346–353

    PubMed  Google Scholar 

  25. Smith SL, Wastie ML, Forster I (2001) Radionuclide bone scintigraphy in the detection of significant complications after total knee joint replacement. Clin Radiol 56:221–224

    Article  PubMed  CAS  Google Scholar 

  26. Temmerman OP, Raijmakers PG, Berkhof J et al (2006) Diagnostic accuracy and interobserver variability of plain radiography, subtraction arthrography, nuclear arthrography, and bone scintigraphy in the assessment of aseptic femoral component loosening. Arch Orthop Trauma Surg 126:316–323

    Article  PubMed  Google Scholar 

  27. Temmerman OP, Raijmakers PG, Berkhof J et al (2005) Accuracy of diagnostic imaging techniques in the diagnosis of aseptic loosening of the femoral component of a hip prosthesis: a meta-analysis. J Bone Joint Surg [Br] 87:781–785

    Google Scholar 

  28. Temmerman OP, Raijmakers PG, David EF et al (2004) A comparison of radiographic and scintigraphic techniques to assess aseptic loosening of the acetabular component in a total hip replacement. J Bone Joint Surg [Am] 86-A:2456–2463

  29. Utz JA, Lull RJ, Galvin EG (1986) Asymptomatic total hip prosthesis: natural history determined using Tc-99 m MDP bone scans. Radiology 161:509–512

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Institut für Nuklearmedizin und Röntgendiagnostik, Luzerner Kantonsspital, CH-6000, Luzern 16, Schweiz

    K. Strobel, I. Steurer-Dober, M.W. Huellner, P. Veit-Haibach & B. Allgayer

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  1. K. Strobel
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  2. I. Steurer-Dober
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  3. M.W. Huellner
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  4. P. Veit-Haibach
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  5. B. Allgayer
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Correspondence to K. Strobel.

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Strobel, K., Steurer-Dober, I., Huellner, M. et al. Stellenwert der SPECT/CT bei Knie- und Hüftgelenkprothesen. Radiologe 52, 629–637 (2012). https://doi.org/10.1007/s00117-011-2270-3

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  • DOI: https://doi.org/10.1007/s00117-011-2270-3

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