Use of non-invasive test with hybrid technology using the 18F-FDG as PET / MRI associated with metal artifact suppression and magnetic susceptibility (MAVRIC) techniques for the diagnosis of total knee prosthesis infection

• Grant number: 17/25540-9
• Support Opportunities: Regular Research Grants
• Duration: May 01, 2018 - October 31, 2020
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Marco Kawamura Demange
• Grantee: Marco Kawamura Demange
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: Ana Lucia Lei Munhoz Lima ; Carlos Alberto Buchpiguel ; Eloisa Silva Dutra de Oliveira Bonfá ; Gilberto Luís Camanho ; Rodrigo Calil Teles Abdo

Abstract

Total Knee Arthroplasty (TKA) is a highly successful procedure in orthopedics and with the aging population and increasing demand for quality of life have increased its indication. Sometimes complications of this procedure can occur and Periprosthetic Joint Infection (PJI) is one of the most complicated to manage. The diagnosis of total knee arthroplasty infection remains a challenge for orthopedists worldwide. A misdiagnosis can lead to inadequate treatment and can cause major complications for the patient. Currently, the method used for the diagnosis of PJI depends on the joint aspiration and sometimes the diagnosis is made after a surgical procedure. However, this an invasive method and can lead to other complications for the patient. FDG-PET, a non-invasive method, provides promising results for PJI evaluation. However, there is a lack of standardization in the interpretation of imaging findings. In addition, a new sequence of MRI images with MAVRIC (multiaquisition variable ressonance image combination) has been used in patients with metal implants in the joints with optimal results.The purpose of this study is to compare the results of tests that are already used for the diagnosis of PJI according to the International Society of Prosthesis Infection, with the measurement of alpha defensin in synovial fluid that has shown very encouraging results and the non-invasive test with hybrid technology using the 18F-FDG radiopharmaceutical as PET / MRI associated with metal artifact suppression and magnetic susceptibility (MAVRIC) techniques for the diagnosis of PJI in patients with indication for revision of knee arthroplasty. (AU)