The Role of Nuclear Medicine Imaging with 18F-FDG PET/CT, Combined 111In-WBC/99mTc-Nanocoll, and 99mTc-HDP SPECT/CT in the Evaluation of Patients with Chronic Problems after TKA or THA in a Prospective Study

Ramune Aleksyniene, Victor Iyer, Henrik Christian Bertelsen, Majbritt Frost Nilsson, Vesal Khalid, Henrik Carl Schønheyder, Lone Heimann Larsen, Poul Torben Nielsen, Andreas Kappel, Trine Rolighed Thomsen, Jan Lorenzen, Iben Ørsted, Ole Simonsen, Peter Lüttge Jordal, Sten Rasmussen

Research output: Contribution to journalJournal articleResearchpeer-review

5 Citations (Scopus)
49 Downloads (Pure)


Background: The aim of this prospective study was to assess the diagnostic value of nuclear imaging with 18F-FDG PET/CT (FDG PET/CT), combined 111In-WBC/99mTc-Nanocoll, and 99mTc-HDP SPECT/CT (dual-isotope WBC/bone marrow scan) for patients with chronic problems related to knee or hip prostheses (TKA or THA) scheduled by a structured multidisciplinary algorithm. Materials and Methods: Fifty-five patients underwent imaging with 99mTc–HDP SPECT/CT (bone scan), dual-isotope WBC/bone marrow scan, and FDG PET/CT. The final diagnosis of prosthetic joint infection (PJI) and/or loosening was based on the intraoperative findings and microbiological culture results and the clinical follow-up. Results: The diagnostic performance of dual-isotope WBC/bone marrow SPECT/CT for PJI showed a sensitivity of 100% (CI 0.74–1.00), a specificity of 97% (CI 0.82–1.00), and an accuracy of 98% (CI 0.88–1.00); for PET/CT, the sensitivity, specificity, and accuracy were 100% (CI 0.74–1.00), 71% (CI 0.56–0.90), and 79% (CI 0.68–0.93), respectively. Conclusions: In a standardized prospectively scheduled patient group, the results showed highly specific performance of combined dual-isotope WBC/bone marrow SPECT/CT in confirming chronic PJI. FDG PET/CT has an appropriate accuracy, but the utility of its use in the clinical diagnostic algorithm of suspected PJI needs further evidence.
Original languageEnglish
Article number681
Issue number3
Publication statusPublished - 10 Mar 2022


  • Bone scan
  • Dual-isotope WBC/bone marrow scan
  • Hybrid imaging
  • Labeled leucocyte imaging
  • Nuclear imaging
  • Periprosthetic infection
  • Prosthetic joint infection

Cite this