{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:08:35Z","timestamp":1780492115019,"version":"3.54.1"},"reference-count":57,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000082","name":"Division of Graduate Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000082","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The diagnostic accuracy of imaging modalities in periprosthetic joint infections (PJIs) remains uncertain. This study assessed and compared the performance of different imaging techniques for diagnosing PJI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis of studies published in PubMed and Embase (1 January 2000 to 1 March 2024) was conducted. Eligible studies included adults (\u226518 years), applied a valid reference standard for PJI diagnosis, and provided sufficient data to construct 2\u2009\u00d7\u20092 contingency tables. Imaging modalities included white blood cell scintigraphy (WBCS), FDG\u2010PET\/CT, antigranulocyte scintigraphy (AGS), bone scintigraphy (BS), magnetic resonance imaging (MRI), computed tomography (CT) and related combinations. Risk of bias was assessed using the QUADAS\u20102 tool. A bivariate random\u2010effects model estimated pooled diagnostic odds ratios, sensitivities, and specificities with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty studies (1263 PJI cases, 4700 controls) were included. Pooled sensitivity and specificity were as follows: WBCS\u2010SPECT\/CT: 87.1% (95% CI, 31.7\u201399.0) and 94.1% (95% CI, 87.5\u201397.3); WBCS\u2010BMS: 79.7% (95% CI, 58.3\u201391.7) and 94.2% (95% CI, 91.0\u201396.3); WBCS: 88.1% (95% CI, 73.8\u201395.1) and 80.0% (95% CI, 62.2\u201390.7); FDG\u2010PET (\u00b1PET\/CT): 88.1% (95% CI, 79.9\u201393.2) and 87.2% (95% CI, 76.3\u201393.5); BS\u2010WBCS: 59.5% (95% CI, 43.2\u201373.9) and 96.6% (95% CI, 92.2\u201398.6); BS: 89.3% (95% CI, 80.9\u201394.2) and 74.1% (95% CI, 59.0\u201385.0); AGS: 89.1% (95% CI, 76.8\u201395.3) and 73.0% (95% CI, 63.1\u201381.0). No eligible studies were identified for MRI or CT. Substantial heterogeneity was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diagnostic performance varied substantially, and no modality consistently demonstrated superior accuracy. WBCS showed the most stable results, particularly when combined with BS or BMS. Given the heterogeneity and variability in specificity, imaging should complement comprehensive diagnostic evaluation rather than be used in isolation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>2a\u20133a, systematic review and meta\u2010analysis of retrospective cohort and case\u2010control studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70423","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:26:02Z","timestamp":1780489562000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Imaging modalities demonstrate moderate and heterogeneous diagnostic accuracy for periprosthetic joint infection: A systematic review and meta\u2010analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1803-3981","authenticated-orcid":false,"given":"Armita Armina","family":"Abedi","sequence":"first","affiliation":[{"name":"International Consensus on Orthopedic Infections Organization Philadelphia Pennsylvania USA"},{"name":"Department of Orthopaedic Surgery and Traumatology Copenhagen University Hospital Bispebjerg Copenhagen Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Tarabichi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Mayo Clinic Arizona Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andor Waltherus Johannes Maria","family":"Glaudemans","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javad","family":"Parvizi","sequence":"additional","affiliation":[{"name":"International Joint Center Acibadem University Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Imaging Working Group for the Unified PJI Definition Task Force","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"American Academy of Orthopaedic Surgeons. Evidence Based Clinical Practice Guideline for Diagnosis and Prevention of Periprosthetic Joint Infections. Published 2019 Mar 11. 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