Preclinical Evaluation of Photoacoustic Imaging as a Novel Noninvasive Approach to Detect an Orthopaedic Implant Infection. (February 2017)

• Record Type: Journal Article
• Authors: Wang, Yu; Thompson, John M.; Ashbaugh, Alyssa G.; Khodakivskyi, Pavlo; Budin, Ghyslain; Sinisi, Riccardo; Heinmiller, Andrew; van Oosten, Marleen; van Dijl, Jan Maarten; van Dam, Gooitzen M.; Francis, Kevin P.; Bernthal, Nicholas M.; Dubikovskaya, Elena A.; Miller, Lloyd S.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 25(2017)Supplement 1
• Publication Date: 2017-02
• Subjects: Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-16-00630
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Introduction: Diagnosing prosthetic joint infection (PJI) poses significant challenges, and current modalities are fraught with low sensitivity and/or potential morbidity. Photoacoustic imaging (PAI) is a novel ultrasound-based modality with potential for diagnosing PJI safely and noninvasively. Materials: In an established preclinical mouse model of bioluminescent Staphylococcus aureus PJI, fluorescent indocyanine green (ICG) was conjugated to β-cyclodextrin (CDX-ICG) or teicoplanin (Teic-ICG) and injected intravenously for 1 week postoperatively. Daily fluorescent imaging and PAI were used to localize and quantify tracer signals. Results were analyzed using 2-way analysis of variance. Results: Fluorescence clearly localized to the site of infection and was significantly higher with Teic-ICG compared with CDX-ICG ( P = 0.046) and ICG alone ( P = 0.0087). With PAI, the photoacoustic signal per volumetric analysis was substantially higher and better visualized with Teic-ICG compared with CDX-ICG and ICG alone, and colocalized well with bioluminescence and fluorescence imaging. Conclusion: Photoacoustic imaging successfully localized PJI in this proof-of-concept study and demonstrates potential for clinical translation in orthopaedics.