PMID- 17138732
OWN - NLM
STAT- MEDLINE
DCOM- 20070305
LR  - 20220318
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 47
IP  - 12
DP  - 2006 Dec
TI  - Usefulness of hybrid SPECT/CT in 99mTc-HMPAO-labeled leukocyte scintigraphy for 
      bone and joint infections.
PG  - 1908-13
AB  - White blood cell scanning with (99m)Tc-hexamethylpropylene amine oxime (HMPAO) 
      has proven highly sensitive and specific in the diagnosis and follow-up of 
      patients with suspected osteomyelitis. The aim of this prospective study was to 
      evaluate the usefulness of SPECT and transmission CT performed simultaneously 
      using a hybrid imaging device for the functional anatomic mapping of bone and 
      joint infections. METHODS: (99m)Tc-HMPAO scintigraphy was performed on 28 
      consecutive patients: 15 with suspected bone infection (group 1) and 13 with 
      suspected orthopedic implant infection (group 2). Planar scans were acquired 30 
      min, 4 h, and 24 h after injection. SPECT/CT was obtained 6 h after tracer 
      injection, using a dual-head gamma-camera coupled with a low-power x-ray tube. In 
      all patients, scintigraphic results were matched with the results of surgery or 
      cultures and of clinical follow-up. RESULTS: (99m)Tc-HMPAO scintigraphy was 
      true-positive for infection in 18 of 28 patients (for a total of 21 sites of 
      uptake) and true-negative in 10 of 28 subjects. SPECT/CT provided an accurate 
      anatomic localization of all positive foci. With regard to the final diagnosis, 
      SPECT/CT added a significant clinical contribution in 10 of 28 patients (35.7%). 
      In fact, SPECT/CT differentiated soft-tissue from bone involvement both in 
      patients with osteomyelitis and in patients with orthopedic implants, allowed 
      correct diagnosis of osteomyelitis in patients with structural alterations after 
      trauma, and identified synovial infection without prosthesis involvement in 
      patients with a knee implant. CONCLUSION: Our results indicate that SPECT/CT 
      performed using a hybrid device can improve imaging with (99m)Tc-HMPAO-labeled 
      leukocytes in patients with suspected osteomyelitis by providing accurate 
      anatomic localization and precise definition of the extent of infection.
FAU - Filippi, Luca
AU  - Filippi L
AD  - Department of Biopathology and Diagnostic Imaging, University of Rome Tor 
      Vergata, Rome, Italy.
FAU - Schillaci, Orazio
AU  - Schillaci O
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (Radiopharmaceuticals)
RN  - 3B744AG22N (Technetium Tc 99m Exametazime)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arthritis, Infectious/*diagnosis
MH  - Bone Diseases, Infectious/*diagnosis
MH  - Female
MH  - Humans
MH  - Image Enhancement/methods
MH  - Leukocytes/*diagnostic imaging
MH  - Male
MH  - Middle Aged
MH  - Radiopharmaceuticals
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - *Subtraction Technique
MH  - *Technetium Tc 99m Exametazime
MH  - Tomography, Emission-Computed, Single-Photon/*methods
MH  - Tomography, X-Ray Computed/*methods
EDAT- 2006/12/02 09:00
MHDA- 2007/03/06 09:00
CRDT- 2006/12/02 09:00
PHST- 2006/12/02 09:00 [pubmed]
PHST- 2007/03/06 09:00 [medline]
PHST- 2006/12/02 09:00 [entrez]
AID - 47/12/1908 [pii]
PST - ppublish
SO  - J Nucl Med. 2006 Dec;47(12):1908-13.