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Title: Indium-111 chloride imaging in the detection of infected prostheses

Abstract

Thirty-three patients with painful joint prostheses and a suspicion of infection were imaged with (/sup 111/In)chloride. A final diagnosis was established by culture in 19. Of these, 12 were categorized as true positives and three as true negatives. There were two false-positive studies, occurring in patients with knee prostheses. In both, the culture was obtained by aspiration. The sensitivity was 86%, specificity 60%, and accuracy 79%. Seventeen of the proven cases had bone imaging prior to (/sup 111/In)chloride imaging. All 17 static images were positive and were not helpful in differentiating loosening from infection. Using increased uptake on the blood-pool image as a criteria for infection, the sensitivity was 89%, but the specificity was 0. Adding flow studies made little difference in interpreting the blood-pool images. This study shows that (/sup 111/In)chloride imaging is more accurate in evaluating infection in prosthesis than bone imaging.

Authors:
; ; ; ;
Publication Date:
Research Org.:
Univ. of Texas Medical Branch, Galveston
OSTI Identifier:
5645932
Resource Type:
Journal Article
Resource Relation:
Journal Name: J. Nucl. Med.; (United States); Journal Volume: 26:7
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLOOD FLOW; SCINTISCANNING; INFECTIOUS DISEASES; DIAGNOSIS; BONE JOINTS; INDIUM 111; INDIUM CHLORIDES; PATIENTS; PROSTHESES; BETA DECAY RADIOISOTOPES; BODY; CHLORIDES; CHLORINE COMPOUNDS; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; HALIDES; HALOGEN COMPOUNDS; INDIUM COMPOUNDS; INDIUM ISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICAL SUPPLIES; MINUTES LIVING RADIOISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; SKELETON 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics

Citation Formats

Sayle, B.A., Fawcett, H.D., Wilkey, D.J., Cierny, G. III, and Mader, J.T. Indium-111 chloride imaging in the detection of infected prostheses. United States: N. p., 1985. Web.
Sayle, B.A., Fawcett, H.D., Wilkey, D.J., Cierny, G. III, & Mader, J.T. Indium-111 chloride imaging in the detection of infected prostheses. United States.
Sayle, B.A., Fawcett, H.D., Wilkey, D.J., Cierny, G. III, and Mader, J.T. 1985. "Indium-111 chloride imaging in the detection of infected prostheses". United States. doi:.
@article{osti_5645932,
title = {Indium-111 chloride imaging in the detection of infected prostheses},
author = {Sayle, B.A. and Fawcett, H.D. and Wilkey, D.J. and Cierny, G. III and Mader, J.T.},
abstractNote = {Thirty-three patients with painful joint prostheses and a suspicion of infection were imaged with (/sup 111/In)chloride. A final diagnosis was established by culture in 19. Of these, 12 were categorized as true positives and three as true negatives. There were two false-positive studies, occurring in patients with knee prostheses. In both, the culture was obtained by aspiration. The sensitivity was 86%, specificity 60%, and accuracy 79%. Seventeen of the proven cases had bone imaging prior to (/sup 111/In)chloride imaging. All 17 static images were positive and were not helpful in differentiating loosening from infection. Using increased uptake on the blood-pool image as a criteria for infection, the sensitivity was 89%, but the specificity was 0. Adding flow studies made little difference in interpreting the blood-pool images. This study shows that (/sup 111/In)chloride imaging is more accurate in evaluating infection in prosthesis than bone imaging.},
doi = {},
journal = {J. Nucl. Med.; (United States)},
number = ,
volume = 26:7,
place = {United States},
year = 1985,
month = 7
}
  • Indium-111-labeled leukocyte scanning is a highly sensitive and specific method of detecting abscesses. This report describes a patient with polycystic kidneys and a single infected cyst. Ultrasound could not determine which cyst was infected, but the infected cyst could be localized by (/sup 111/In)leukocyte imaging in conjunction with a (/sup 99m/Tc)DMSA renal scan. The two radionuclide studies were used to identify an infected renal cyst and direct ultrasound guided aspiration.
  • Two hundred and fifty-eight patients with clinically suspected inflammatory processes were studied. Seventy-two images were categorized as true positive; 211 as true negative. There were nine false-positive studies, four of which were due to activity in beds of excised organs. There were six false-negative studies, four of which were due to walled-off abscesses found either at surgery or biopsy. The sensitivity was 92%, the specificity 95%, and the accuracy 94%. This study shows that indium-111 chloride imaging provides a reliable way to locate inflammatory processes and overcomes the disadvantages of other imaging agents, for example gastrointestinal activity or the demonstrationmore » of healing surgical wounds with gallium-67, and the false-positive images due to cystic fibrosis and other respiratory diseases, or accessory spleens as seen with In-111-labeled white cells.« less
  • Indium-111 chloride imaging plays an important role in differentiating intracortical osteoid osteoma from chronic cortical abscess. The study also may be useful in the detection of intramedullary osteoid osteoma. Four patients who greatly benefited from indium-111 chloride imaging are presented.
  • Twenty-nine patients with aplastic anemia and 11 patients with myelofibrosis were evaluated with indium-111 chloride bone-marrow imaging, ferrokinetics, and bone-marrow core biopsies. There was good correlation between the erythrocyte cellularity of the marrow and the In-111 bone-marrow scan grades in most patients. In some, the overall scan grade tended to underestimate the erythroid elements because the core biopsy had been taken from the area of the greatest radionuclide concentration on the scan. In patients with aplastic anemia, there was good correlation between the plasma iron clearance t1/2 and the scan grade. Less agreement was found in the comparison between themore » Fe-59 sacral and organ counts and the red-cell iron utilization. In patients with myelofibrosis, there was poor correlation between the surface counts over the sacrum and the red-cell iron utilization. Plasma iron clearances were abnormally short and were unrelated to the transferrin saturation levels. Eighteen patients were studied several times to evaluate their responses to steroid therapy. In all, there was good correlation between the bone-marrow imaging, the erythrocyte cellularity, ferrokinetics, and the patient's response to therapy. Indium-111 bone-marrow imaging is useful both in evaluating marrow erythroid activity and in following the response to therapy in patients with these diseases.« less