The role of FDG-PET in distinguishing between septic and aseptic loosening in hip prosthesis: a review of literature

Infection in prosthesis surgery is very dangerous because it changes the patient’s prognosis. Differential diagnosis between septic and aseptic loosening is fundamental in order to apply the correct treatment. The correct diagnostic approach is still debated in literature. The aim of this study was to perform a review of literature evaluating positron emission tomography (PET) capacity to distinguish between septic and aseptic loosening in hip prosthesis. Research was done principally among medical archives. Five studies were selected which satisfied the required characteristics, and a weighted average of sensitivity and specificity of the different studies was determined. The fluorodeoxyglucose positron emission tomography (FDG-PET) sensitivity in individuating hip prosthesis infections was 82.8% and specificity was 87.3%. Positron emission tomography based on 2-fluoro-2-deoxy-D-glucose could be a valid option if research is able to find an uptake pattern specific for septic and aseptic loosening.