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PLOS ONE  2013 

Use of Anti-Granulocyte Scintigraphy with 99mTc-Labeled Monoclonal Antibodies for the Diagnosis of Periprosthetic Infection in Patients after Total Joint Arthroplasty: A Diagnostic Meta-Analysis

DOI: 10.1371/journal.pone.0069857

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Abstract:

The accurate diagnosis of periprosthetic joint infections (PJI) is crucial for therapy and the prevention of complications. No diagnostic test of PJI is 100% accurate. The aim of this study was to assess the use of anti-granulocyte scintigraphy using 99 mTc-labeled monoclonal antibodies to diagnose PJI after total joint arthroplasty. A systematic search of all relevant studies published through January 2013 was conducted using the MEDLINE, EMBASE, OVID, and ScienceDirect databases. Observational studies that assessed the accuracy of the anti-granulocyte scintigraphy with monoclonal antibodies or antibody fragments labeled with technetium 99 m in diagnosis for PJI and provided data on specificity and sensitivity were identified. Standard methods recommended for meta-analysis of diagnostic accuracy were used. Nineteen studies were eligible for inclusion. The results demonstrated that the area under the summary receiver operator curve was 0.88, and the diagnostic accuracy (Q*) was 0.81. Additionally, the diagnostic odds ratio (DOR) was 18.76 with a corresponding 95% confidence interval of 10.45–33.68. The pooled sensitivity and specificity of the diagnostic method for the diagnosis of PJI were 83% and 79%, respectively, while the pooled positive likelihood ratio (PLR) was 3.56, and the negative likelihood ratio (NLR) was 0.26. Anti-granulocyte scintigraphy using 99 mTc-labeled monoclonal antibodies has a reasonable role in the diagnosis of PJI after total joint arthroplasty. Due to the limitations of the present meta-analysis, additional high-quality original studies are required to confirm the predictive value.

References

[1]  Love C, Marwin SE, Palestro CJ (2009) Nuclear medicine and the infected joint replacement. Semin Nucl Med 39: 66–78.
[2]  Love C, Tomas MB, Marwin SE, Pugliese PV, Palestro CJ (2001) Role of nuclear medicine in diagnosis of the infected joint replacement. Radiographics 21: 1229–1238.
[3]  Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, et al. (2008) Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty 23: 984–991.
[4]  Boubaker A, Delaloye AB, Blanc CH, Dutoit M, Leyvraz PF, et al. (1995) Immunoscintigraphy with antigranulocyte monoclonal antibodies for the diagnosis of septic loosening of hip prostheses. Eur J Nucl Med 22: 139–147.
[5]  Pring DJ, Henderson RG, Keshavarzian A, Rivett AG, Krausz T, et al. (1986) Indium-granulocyte scanning in the painful prosthetic joint. AJR Am J Roentgenol 147: 167–172.
[6]  Spangehl MJ, Masri BA, O'Connell JX, Duncan CP (1999) Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am 81: 672–683.
[7]  Love C, Marwin SE, Tomas MB, Krauss ES, Tronco GG, et al. (2004) Diagnosing infection in the failed joint replacement: a comparison of coincidence detection 18F-FDG and 111In-labeled leukocyte/99 mTc-sulfur colloid marrow imaging. J Nucl Med 45: 1864–1871.
[8]  Reinartz P (2009) FDG-PET in patients with painful hip and knee arthroplasty: technical breakthrough or just more of the same. Q J Nucl Med Mol Imaging 53: 41–50.
[9]  Schillaci O, Danieli R, Manni C, Simonetti G (2004) Is SPECT/CT with a hybrid camera useful to improve scintigraphic imaging interpretation? Nucl Med Commun 25: 705–710.
[10]  Bauer TW, Parvizi J, Kobayashi N, Krebs V (2006) Diagnosis of periprosthetic infection. J Bone Joint Surg Am 88: 869–882.
[11]  Parvizi J, Ghanem E, Menashe S, Barrack RL, Bauer TW (2006) Periprosthetic infection: what are the diagnostic challenges? J Bone Joint Surg Am 88 Suppl 4138–147.
[12]  Aliabadi P, Tumeh SS, Weissman BN, McNeil BJ (1989) Cemented total hip prosthesis: radiographic and scintigraphic evaluation. Radiology 173: 203–206.
[13]  Magnuson JE, Brown ML, Hauser MF, Berquist TH, Fitzgerald RJ, et al. (1988) In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities. Radiology 168: 235–239.
[14]  Demirkol MO, Adalet I, Unal SN, Tozun R, Cantez S (1997) 99Tc(m)-polyclonal IgG scintigraphy in the detection of infected hip and knee prostheses. Nucl Med Commun 18: 543–548.
[15]  Virgili G, Conti AA, Murro V, Gensini GF, Gusinu R (2009) Systematic reviews of diagnostic test accuracy and the Cochrane collaboration. Intern Emerg Med 4: 255–258.
[16]  Whiting P, Rutjes AW, Dinnes J, Reitsma J, Bossuyt PM, et al. (2004) Development and validation of methods for assessing the quality of diagnostic accuracy studies. Health Technol Assess 8: 1–234.
[17]  Whiting P, Rutjes AW, Reitsma JB, Glas AS, Bossuyt PM, et al. (2004) Sources of variation and bias in studies of diagnostic accuracy: a systematic review. Ann Intern Med 140: 189–202.
[18]  Juni P, Witschi A, Bloch R, Egger M (1999) The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 282: 1054–1060.
[19]  Whiting P, Harbord R, Kleijnen J (2005) No role for quality scores in systematic reviews of diagnostic accuracy studies. BMC Med Res Methodol 5: 19.
[20]  Pai M, McCulloch M, Gorman JD, Pai N, Enanoria W, et al. (2004) Systematic reviews and meta-analyses: an illustrated, step-by-step guide. Natl Med J India 17: 86–95.
[21]  Pai M, McCulloch M, Enanoria W, Colford JJ (2004) Systematic reviews of diagnostic test evaluations: What's behind the scenes? ACP J Club 141: A11–A13.
[22]  Deeks JJ (2001) Systematic reviews in health care: Systematic reviews of evaluations of diagnostic and screening tests. BMJ 323: 157–162.
[23]  Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM (2003) The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol 56: 1129–1135.
[24]  Jones CM, Athanasiou T (2005) Summary receiver operating characteristic curve analysis techniques in the evaluation of diagnostic tests. Ann Thorac Surg 79: 16–20.
[25]  Walter SD (2002) Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med 21: 1237–1256.
[26]  Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58: 882–893.
[27]  Gratz S, Reize P, Pfestroff A, Hoffken H (2012) Intact versus fragmented 99 mTc-monoclonal antibody imaging of infection in patients with septically loosened total knee arthroplasty. J Int Med Res 40: 1335–1342.
[28]  Sousa R, Massada M, Pereira A, Fontes F, Amorim I, et al. (2011) Diagnostic accuracy of combined 99 mTc-sulesomab and 99 mTc-nanocolloid bone marrow imaging in detecting prosthetic joint infection. Nucl Med Commun 32: 834–839.
[29]  Graute V, Feist M, Lehner S, Haug A, Muller PE, et al. (2010) 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.
[30]  Simonsen L, Buhl A, Oersnes T, Duus B (2007) White blood cell scintigraphy for differentiation of infection and aseptic loosening: a retrospective study of 76 painful hip prostheses. Acta Orthop 78: 640–647.
[31]  Pakos EE, Fotopoulos AD, Stafilas KS, Gavriilidis I, Al BG, et al. (2007) Use of (99 m)Tc-sulesomab for the diagnosis of prosthesis infection after total joint arthroplasty. J Int Med Res 35: 474–481.
[32]  Iyengar KP, Vinjamuri S (2005) Role of 99 mTc Sulesomab in the diagnosis of prosthetic joint infections. Nucl Med Commun 26: 489–496.
[33]  Larikka MJ, Ahonen AK, Niemela O, Junila JA, Hamalainen MM, et al. (2002) Comparison of 99 mTc ciprofloxacin, 99 mTc white blood cell and three-phase bone imaging in the diagnosis of hip prosthesis infections: improved diagnostic accuracy with extended imaging time. Nucl Med Commun 23: 655–661.
[34]  von Rothenburg T, Schoellhammer M, Schaffstein J, Koester O, Schmid G (2004) Imaging of infected total arthroplasty with Tc-99 m-labeled antigranulocyte antibody Fab'fragments. Clin Nucl Med 29: 548–551.
[35]  Rubello D, Casara D, Maran A, Avogaro A, Tiengo A, et al. (2004) Role of anti-granulocyte Fab' fragment antibody scintigraphy (LeukoScan) in evaluating bone infection: acquisition protocol, interpretation criteria and clinical results. Nucl Med Commun 25: 39–47.
[36]  Vicente AG, Almoguera M, Alonso JC, Heffernan AJ, Gomez A, et al. (2004) Diagnosis of orthopedic infection in clinical practice using Tc-99 m sulesomab (antigranulocyte monoclonal antibody fragment Fab'2). Clin Nucl Med 29: 781–785.
[37]  Gratz S, Schipper ML, Dorner J, Hoffken H, Becker W, et al. (2003) LeukoScan for imaging infection in different clinical settings: a retrospective evaluation and extended review of the literature. Clin Nucl Med 28: 267–276.
[38]  Ivancevic V, Perka C, Hasart O, Sandrock D, Munz DL (2002) Imaging of low-grade bone infection with a technetium-99 m labelled monoclonal anti-NCA-90 Fab' fragment in patients with previous joint surgery. Eur J Nucl Med Mol Imaging 29: 547–551.
[39]  Ryan PJ (2002) Leukoscan for orthopaedic imaging in clinical practice. Nucl Med Commun 23: 707–714.
[40]  Devillers A, Garin E, Polard JL, Poirier JY, Arvieux C, et al. (2000) Comparison of Tc-99 m-labelled antileukocyte fragment Fab' and Tc-99 m-HMPAO leukocyte scintigraphy in the diagnosis of bone and joint infections: a prospective study. Nucl Med Commun 21: 747–753.
[41]  Sciuk J, Puskas C, Greitemann B, Schober O (1992) White blood cell scintigraphy with monoclonal antibodies in the study of the infected endoprosthesis. Eur J Nucl Med 19: 497–502.
[42]  Gratz S, Behr TM, Reize P, Pfestroff A, Kampen WU, et al. (2009) (99 m)Tc-Fab' fragments (sulesomab) for imaging septically loosened total knee arthroplasty. J Int Med Res 37: 54–67.
[43]  Rubello D, Rampin L, Banti E, Massaro A, Cittadin S, et al. (2008) Diagnosis of infected total knee arthroplasty with anti-granulocyte scintigraphy: the importance of a dual-time acquisition protocol. Nucl Med Commun 29: 331–335.
[44]  Klett R, Kordelle J, Stahl U, Khalisi A, Puille M, et al. (2003) Immunoscintigraphy of septic loosening of knee endoprosthesis: a retrospective evaluation of the antigranulocyte antibody BW 250/183. Eur J Nucl Med Mol Imaging 30: 1463–1466.
[45]  Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, et al. (2011) New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 469: 2992–2994.
[46]  Fitzgerald RJ, Nolan DR, Ilstrup DM, Van Scoy RE, Washington JN, et al. (1977) Deep wound sepsis following total hip arthroplasty. J Bone Joint Surg Am 59: 847–855.
[47]  Greidanus NV, Masri BA, Garbuz DS, Wilson SD, McAlinden MG, et al. (2007) Use of erythrocyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. A prospective evaluation. J Bone Joint Surg Am 89: 1409–1416.
[48]  Schinsky MF, Della VC, Sporer SM, Paprosky WG (2008) Perioperative testing for joint infection in patients undergoing revision total hip arthroplasty. J Bone Joint Surg Am 90: 1869–1875.
[49]  O'Neill DA, Harris WH (1984) Failed total hip replacement: assessment by plain radiographs, arthrograms, and aspiration of the hip joint. J Bone Joint Surg Am 66: 540–546.
[50]  Tsaras G, Maduka-Ezeh A, Inwards CY, Mabry T, Erwin PJ, et al. (2012) Utility of intraoperative frozen section histopathology in the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am 94: 1700–1711.
[51]  Al-Sheikh W, Sfakianakis GN, Mnaymneh W, Hourani M, Heal A, et al. (1985) Subacute and chronic bone infections: diagnosis using In-111, Ga-67 and Tc-99 m MDP bone scintigraphy, and radiography. Radiology 155: 501–506.
[52]  Becker W, Palestro CJ, Winship J, Feld T, Pinsky CM, et al. (1996) Rapid imaging of infections with a monoclonal antibody fragment (LeukoScan). Clin Orthop Relat Res: 263–272.
[53]  Skehan SJ, White JF, Evans JW, Parry-Jones DR, Solanki CK, et al. (2003) Mechanism of accumulation of 99 mTc-sulesomab in inflammation. J Nucl Med 44: 11–18.
[54]  Pakos EE, Trikalinos TA, Fotopoulos AD, Ioannidis JP (2007) Prosthesis infection: diagnosis after total joint arthroplasty with antigranulocyte scintigraphy with 99 mTc-labeled monoclonal antibodies–a meta-analysis. Radiology 242: 101–108.
[55]  Diamond GA (1992) Off Bayes: effect of verification bias on posterior probabilities calculated using Bayes' theorem. Med Decis Making 12: 22–31.
[56]  Mol BW, Lijmer JG, van der Meulen J, Pajkrt E, Bilardo CM, et al. (1999) Effect of study design on the association between nuchal translucency measurement and Down syndrome. Obstet Gynecol 94: 864–869.
[57]  Cooper HJ, Della VC (2013) Advances in the diagnosis of periprosthetic joint infection. Expert Opin Med Diagn 7: 257–263.
[58]  Gallagher EJ (1998) Clinical utility of likelihood ratios. Ann Emerg Med 31: 391–397.
[59]  Jaeschke R, Guyatt G, Sackett DL (1994) Users' guides to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA 271: 389–391.

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