Overview
Following intravenous injection of [F-18]MHF as a bolus, dynamic PET imaging of the lower limbs will be acquired for approximately 90 minutes. The acquired images will be processed and viewed on a MIMVista or similar workstation. The uptake pattern of [F-18]MHF around infected orthopedic knee implant will be determined and compared with its uptake pattern around non-infected knee implants.
This study will look at how [18F]MHF goes into normal knee replacements and those with suspected infection.
Description
This is a study that will test a compound (chemical substance) that has a small amount of radioactivity attached to it. This substance has a natural tendency to go to bacterial infections. The substance is called [18F]MHF and it is given in the form of an injection into a vein. After the substance reaches the infected body region, scans called PET or Positron Emission Tomography, are done. This is similar to having CAT scans or x-rays. Usually a compound called [18]FDG is used for PET scans to detect bacterial infections but this substance can't distinguish between bacterial infections and inflammation. This substance called [18F]MHF does not go to inflamed tissue and may allow bacterial infections to be seen better.
This study will look at how [18F]MHF goes into normal knee replacements and those with suspected infection. This will hopefully lead to the development of better imaging techniques to look at bacterial infections. [18F]MHF is approved by the FDA (Food and Drug Administration) for research.
Eligibility
Inclusion Criteria for symptomatic patient cohort
- Patients must be 18 years of age or older, able to provide written informed consent, and ability to lie still for PET scanning.
- Suspected knee prosthetic infection at least 2 months after original prosthesis placement and who are scheduled to undergo surgery debridement/removal based on the clinical assessment of the referring surgeon.
- Elevated CRP and ESR
Exclusion Criteria for symptomatic patient cohort:
- Undergoing current or recent antimicrobial therapy (within 1 month)
- Significant comorbidity such as renal failure, septic shock, uncontrolled diabetes
- Other clinically likely site of infection
Inclusion Criteria for asymptomatic cohort:
- Patients must be 18 years of age or older, able to provide written informed consent and ability to lie still for PET scanning
- Knee prosthesis in situ without complications for 6 months or longer
Exclusion Criteria for asymptomatic cohort:
- Clinical or laboratory suspicion of knee prosthesis infection
- Recent (within 3 months) or current treatment for infected knee prosthesis
- Significant comorbidity such as renal failure, septic shock, uncontrolled diabetes