AUTHOR=Wang Yiqun , Wang Ruimin , Geng Lei , Li Qingxiao , Qi Erpeng , Shi Yuanyuan , Wang Yanmei , Zheng Qingyuan , Zhang Guoqiang , Chen Jiying , Tian Jiahe 

TITLE=Different uptake patterns of 68Ga-FAPI in aseptic loosening and periprosthetic joint infection of hip arthroplasty: A case series and literature review

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1014463

DOI=10.3389/fmed.2022.1014463

ISSN=2296-858X

ABSTRACT=Abstract
Background
The diagnosis of periprosthetic joint (PJI) infection is always a difficult point in joint surgery research. The current diagnostic criteria are a comprehensive analysis of multiple tests, and there is not yet an effective visual examination that can differentiate aseptic loosening and PJI.
Case presentation
This case report describes four symptomatic total hip arthroplasty patients, two cases of loosening and two cases of infection. Although four cases were correctly diagnosed by tissue culture, preoperative tests and pathological examination could not effectively distinguish infection from noninfection. Based on a preclinical study and theoretical feasibility, 68Ga-FAPI PET/CT was performed. Through 68Ga-FAPI PET/CT scanning, not only were the causes diagnosed correctly, but the lesions were also located.
Conclusions
When the lesion is located between the bone and the prosthesis, 68Ga-FAPI PET/CT could differentiate aseptic loosening from periprosthetic joint infection. 68Ga-FAPI PET/CT has obvious advantages over routine examinations and shows prospective application in detecting PJI.