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Erschienen in: Der Radiologe 7/2012

01.07.2012 | Leitthema

Stellenwert der SPECT/CT bei Knie- und Hüftgelenkprothesen

verfasst von: PD Dr. K. Strobel, I. Steurer-Dober, M.W. Huellner, P. Veit-Haibach, B. Allgayer

Erschienen in: Die Radiologie | Ausgabe 7/2012

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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.
Literatur
1.
Zurück zum Zitat Ahmad R, Kumar GS, Katam K et al (2009) Significance of a „hot patella“ in total knee replacement without primary patellar resurfacing. Knee 16:337–340PubMedCrossRef Ahmad R, Kumar GS, Katam K et al (2009) Significance of a „hot patella“ in total knee replacement without primary patellar resurfacing. Knee 16:337–340PubMedCrossRef
2.
Zurück zum Zitat Aliabadi P, Tumeh SS, Weissman BN et al (1989) Cemented total hip prosthesis: radiographic and scintigraphic evaluation. Radiology 173:203–206PubMed Aliabadi P, Tumeh SS, Weissman BN et al (1989) Cemented total hip prosthesis: radiographic and scintigraphic evaluation. Radiology 173:203–206PubMed
3.
Zurück zum Zitat Berger RA, Crossett LS, Jacobs JJ et al (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153PubMedCrossRef Berger RA, Crossett LS, Jacobs JJ et al (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153PubMedCrossRef
4.
Zurück zum Zitat Berquist TH (2006) Imaging of joint replacement procedures. Radiol Clin North Am 44:419–437PubMedCrossRef Berquist TH (2006) Imaging of joint replacement procedures. Radiol Clin North Am 44:419–437PubMedCrossRef
5.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 36:295–311PubMedCrossRef 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 36:295–311PubMedCrossRef
7.
Zurück zum Zitat 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 16:104–112PubMed 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 16:104–112PubMed
8.
Zurück zum Zitat Filippi L, Schillaci O (2006) Usefulness of hybrid SPECT/CT in 99mTc-HMPAO-labeled leukocyte scintigraphy for bone and joint infections. J Nucl Med 47:1908–1913PubMed Filippi L, Schillaci O (2006) Usefulness of hybrid SPECT/CT in 99mTc-HMPAO-labeled leukocyte scintigraphy for bone and joint infections. J Nucl Med 47:1908–1913PubMed
9.
Zurück zum Zitat Gelman MI, Coleman RE, Stevens PM et al (1978) Radiography, radionuclide imaging, and arthrography in the evaluation of total hip and knee replacement. Radiology 128:677–682PubMed Gelman MI, Coleman RE, Stevens PM et al (1978) Radiography, radionuclide imaging, and arthrography in the evaluation of total hip and knee replacement. Radiology 128:677–682PubMed
10.
Zurück zum Zitat 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 39:892–909PubMedCrossRef 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 39:892–909PubMedCrossRef
11.
Zurück zum Zitat 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 12:49–54PubMedCrossRef 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 12:49–54PubMedCrossRef
12.
Zurück zum Zitat Gill GS, Joshi AB, Mills DM (1999) Total condylar knee arthroplasty. Sixteen- to twenty-one-year results. Clin Orthop Relat Res 367:210–215PubMedCrossRef Gill GS, Joshi AB, Mills DM (1999) Total condylar knee arthroplasty. Sixteen- to twenty-one-year results. Clin Orthop Relat Res 367:210–215PubMedCrossRef
13.
Zurück zum Zitat 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 37:1751–1759CrossRef 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 37:1751–1759CrossRef
14.
Zurück zum Zitat 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–W411CrossRef 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–W411CrossRef
15.
Zurück zum Zitat 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 18:939–944CrossRef 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 18:939–944CrossRef
16.
Zurück zum Zitat 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 12:36CrossRef 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 12:36CrossRef
17.
Zurück zum Zitat Moilanen T, Scott G, Newell M et al (1997) Bone scintigraphic appearance of asymptomatic hydroxyapatite-coated hip arthroplasties. J Arthroplasty 12:380–386PubMedCrossRef Moilanen T, Scott G, Newell M et al (1997) Bone scintigraphic appearance of asymptomatic hydroxyapatite-coated hip arthroplasties. J Arthroplasty 12:380–386PubMedCrossRef
18.
Zurück zum Zitat 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 235:969–976PubMedCrossRef 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 235:969–976PubMedCrossRef
19.
Zurück zum Zitat 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–N60PubMed 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–N60PubMed
20.
Zurück zum Zitat Rosenthall L, Lepanto L, Raymond F (1987) Radiophosphate uptake in asymptomatic knee arthroplasty. J Nucl Med 28:1546–1549PubMed Rosenthall L, Lepanto L, Raymond F (1987) Radiophosphate uptake in asymptomatic knee arthroplasty. J Nucl Med 28:1546–1549PubMed
21.
Zurück zum Zitat Rubello D, Caricasulo D, Borsato N et al (1996) Three-phase bone scan pattern in asymptomatic uncemented total knee arthroplasty. Eur J Nucl Med 23:1400–1403PubMedCrossRef Rubello D, Caricasulo D, Borsato N et al (1996) Three-phase bone scan pattern in asymptomatic uncemented total knee arthroplasty. Eur J Nucl Med 23:1400–1403PubMedCrossRef
22.
Zurück zum Zitat Sacchetti GM, Ghisellini F, Brambilla M et al (1996) Quantitative scintigraphic evaluation of total knee arthroplasties: a feasibility study. Clin Orthop Relat Res 325:181–189PubMedCrossRef Sacchetti GM, Ghisellini F, Brambilla M et al (1996) Quantitative scintigraphic evaluation of total knee arthroplasties: a feasibility study. Clin Orthop Relat Res 325:181–189PubMedCrossRef
23.
Zurück zum Zitat Schillaci O (2009) Hybrid imaging systems in the diagnosis of osteomyelitis and prosthetic joint infection. Q J Nucl Med Mol Imaging 53:95–104PubMed Schillaci O (2009) Hybrid imaging systems in the diagnosis of osteomyelitis and prosthetic joint infection. Q J Nucl Med Mol Imaging 53:95–104PubMed
24.
Zurück zum Zitat Shehab D, Elgazzar AH, Collier BD (2002) Heterotopic ossification. J Nucl Med 43:346–353PubMed Shehab D, Elgazzar AH, Collier BD (2002) Heterotopic ossification. J Nucl Med 43:346–353PubMed
25.
Zurück zum Zitat Smith SL, Wastie ML, Forster I (2001) Radionuclide bone scintigraphy in the detection of significant complications after total knee joint replacement. Clin Radiol 56:221–224PubMedCrossRef Smith SL, Wastie ML, Forster I (2001) Radionuclide bone scintigraphy in the detection of significant complications after total knee joint replacement. Clin Radiol 56:221–224PubMedCrossRef
26.
Zurück zum Zitat 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 126:316–323PubMedCrossRef 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 126:316–323PubMedCrossRef
27.
Zurück zum Zitat 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 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
28.
Zurück zum Zitat 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 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.
Zurück zum Zitat Utz JA, Lull RJ, Galvin EG (1986) Asymptomatic total hip prosthesis: natural history determined using Tc-99 m MDP bone scans. Radiology 161:509–512PubMed Utz JA, Lull RJ, Galvin EG (1986) Asymptomatic total hip prosthesis: natural history determined using Tc-99 m MDP bone scans. Radiology 161:509–512PubMed
Metadaten
Titel
Stellenwert der SPECT/CT bei Knie- und Hüftgelenkprothesen
verfasst von
PD Dr. K. Strobel
I. Steurer-Dober
M.W. Huellner
P. Veit-Haibach
B. Allgayer
Publikationsdatum
01.07.2012
Verlag
Springer-Verlag
Erschienen in
Die Radiologie / Ausgabe 7/2012
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-011-2270-3

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