Complicating osteomyelitis imaged with Tc-99m MDP, In-111 granulocytes, and Ga-67 citrate

Conference · Sat Dec 31 23:00:00 EST 1983 · J. Nucl. Med.; (United States)

OSTI ID:6780911

Schauwecker, D S; Park, H M; Mock, B H; Burt, R W; Kernick, C B; Ruoff, III, A C; Sinn, H J; Wellman, H N; Vamc, R L.R.

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), Journal Name: J. Nucl. Med.; (United States) Vol. 25:5; ISSN JNMEA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ACETYLACETONE
ANIMAL TISSUES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CARBOXYLIC ACID SALTS
CHELATING AGENTS
CITRATES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC USES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
GALLIUM 67
GALLIUM ISOTOPES
HOURS LIVING RADIOISOTOPES
IMAGE PROCESSING
INDIUM 111
INDIUM ISOTOPES
INFECTIVITY
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KETONES
LABELLING
LEUKOCYTES
MATERIALS
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANS
OSTEOMYELITIS
PATIENTS
PROCESSING
RADIOISOTOPE SCANNING
RADIOISOTOPES
REAGENTS
SENSITIVITY ANALYSIS
SKELETAL DISEASES
SKELETON
TECHNETIUM 99
TECHNETIUM ISOTOPES
TISSUES
UPTAKE
USES
YEARS LIVING RADIOISOTOPES