18F-Fluorodeoxyglucose-PET in Prosthetic and Implant Associated Infections.

Implant-associated infections are an expanding clinical challenge as joint arthroplasty, cardiac devices, vascular grafts, and spinal hardware become increasingly common. Periprosthetic joint infection (PJI) alone affects a substantial proportion of revisions, carrying high cost and morbidity. 18F-FDGfluorodeoxyglucose (FDG) PET/CT, leveraging glucose hypermetabolism in inflammatory cells, offers pooled sensitivity of 85% to 89% and specificity of 86% to 93% for PJI, distinguishing infection from expected physiologic postoperative uptake. The 2024 EANM/SNMMI joint guideline (v2.0) standardizes protocols and interpretation criteria across implant types. This review synthesizes pathogenesis, imaging patterns, technical optimization, and emerging modalities for implant infection imaging.