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KMID : 1207720210130030320
Clinics in Orthopedic Surgery
2021 Volume.13 No. 3 p.320 ~ p.328
Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography and Magnetic Resonance Imaging for Adverse Local Tissue Reactions near Metal Implants after Total Hip Arthroplasty: A Preliminary Report
Kimura Makoto

Kaku Nobuhiro
Kubota Yuta
Tagomori Hiroaki
Tsumura Hiroshi
Abstract
Background: Plain computed tomography (CT) and magnetic resonance imaging (MRI) are useful for diagnosing adverse local tissue reactions after metal-on-metal total hip arthroplasty (THA), but metal artifacts can hamper radiological assessments near the implants. We sought to clarify the usefulness of 18F-fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) CT and MRI in the periprosthetic region, which is difficult to assess after THA due to metal artifacts.

Methods: We performed preoperative 18F-FDG-PET/CT and 18F-FDG-PET/MRI, as well as plain CT and MRI, in 11 metal-on-metal THA patients who underwent revision surgery.

Results: Most patients showed high FDG uptake in the metal artifact areas and pseudotumors in the 18-F-FDG-PET/CT and 18-F-FDG-PET/MRI scans. Intraoperative intra-articular macroscopic and histopathological intra-articular granulation tissue findings were suggestive of adverse local tissue reaction.

Conclusions: The enhanced uptake in the metal artifact areas seemed to reflect adverse local tissue reaction. Therefore, 18F-FDG-PET/CT and 18-F-FDG-PET/MRI can be useful for the auxiliary diagnosis of adverse local tissue reactions after metal-on-metal THA.
KEYWORD
Arthroplasty, Computed tomography, Fluorodeoxyglucose F18, Metal-on-metal joint prostheses, Positron-emission tomography
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