Complicating osteomyelitis imaged with Tc-99m MDP, In-111 granulocytes, and Ga-67 citrate
Gallium-67 and 3-phase bone scan (3P) studies, though very sensitive, are not very specific in evaluating suspected osteomyelitis (OM) which is superimposed upon other diseases that cause increased bone turnover (IBT). The authors compared In-111 acetylacetone labeled granulocytes (In-111) GRAN) with 3P in 57 such patients; 29 of these patients had Ga-67 studies as well. In-111 GRAN had a sensitivity of 100% in acute OM, 62% in chronic OM, and a specificity of 96%. Gallium-67 ruled out OM when the study was normal; it diagnosed OM when the relative uptake of Ga-67 exceeded the uptake of Tc-99m MDP, or when the skeletal distribution of Ga-67 was different from that of the TC-99m MDP. Unfortunately, these criteria were met in only 28% of the subjects. The simple approach of increased Ga-67 activity meant OM gave a sensitivity of 100%, but an unacceptable specificity of 38%. Chronic cellulitis or long-standing decubiti were seldom detected by IN-111 GRAN. Clinically obvious soft tissue infections or cellulitis were seen with In-111 GRAN 27% of the time, and 17% of the time with Ga-67. The authors conclude that when added to 3P, In-111 GRAN provided more useful information than did Ga-67. A combination of all 3 studies did not significantly increase the diagnostic yield. Performing In-111 GRAN without 3P in patients with IBT is not recommended since the 3P provides anatomic information that aids in the differentiation of OM from soft tissue infections.
- Research Organization:
- Indiana Univ. School of Medicine, Indianapolis, IN
- OSTI ID:
- 6780911
- Report Number(s):
- CONF-840619-
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
- Country of Publication:
- United States
- Language:
- English
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CITRATES
DIAGNOSTIC USES
LABELLING
GALLIUM 67
INDIUM 111
LEUKOCYTES
OSTEOMYELITIS
DIAGNOSIS
SKELETON
RADIOISOTOPE SCANNING
TECHNETIUM 99
ACETYLACETONE
ANIMAL TISSUES
IMAGE PROCESSING
INFECTIVITY
PATIENTS
SENSITIVITY ANALYSIS
UPTAKE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CARBOXYLIC ACID SALTS
CHELATING AGENTS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
GALLIUM ISOTOPES
HOURS LIVING RADIOISOTOPES
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KETONES
MATERIALS
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANS
PROCESSING
RADIOISOTOPES
REAGENTS
SKELETAL DISEASES
TECHNETIUM ISOTOPES
TISSUES
USES
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics