99mTc-HMPAO-Leukocyte Scintigraphy in Patients with Symptomatic Total Hip or Knee Arthroplasty: Improved Diagnostic Accuracy by Means of Semiquantitative Evaluation

Journal of Nuclear Medicine

Teresio Varetto¹  Ettore Pelosi¹  Michele Pennone¹  Giuseppe Migliaretti¹  Gianni Bisi¹  Marilena Bellò¹  Agostino Maiello¹  Cinzia Baiocco¹ 

关键词: infection radionuclide imaging;    hip prosthesis;    knee prosthesis;    ^99mTc-labeled leukocytes;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The aim of this study was to evaluate the diagnostic value, in suspected infectious prostheses, of 99mTc-labeled hexamethylpropyleneamine oxime (99mTc-HMPAO) leukocyte scintigraphy interpreted with the addition of a semiquantitative analysis. Methods: By means of a retrospective review, we included a group of 78 consecutive patients with suspected hip or knee prosthesis infection. We performed 91 99mTc-HMPAO-leukocyte scintigraphies and examined 95 localizations that were suspect. Images were acquired at 3 different time points after the injection of the labeled leukocytes: 50 min (early images), 4 h, and 24 h (late images). The scintigraphic examinations were independently evaluated by 3 observers; qualitative and semiquantitative analyses were performed. The final diagnosis of infection was based on surgical, histologic, and bacteriologic data and follow-up. Results: On qualitative analysis, sensitivity, specificity, and accuracy were 80.4%–87%, 65.3%–71.4%, and 75.8%–77.9%, respectively. On semiquantitative analysis, sensitivity, specificity, and accuracy were 95.6%, 95.8%, and 95.8%, respectively. The analysis of 95% confidential intervals showed statistically significant differences in specificity and accuracy between semiquantitative and qualitative analyses. Conclusion: In those patients who underwent 99mTc-HMPAO-leukocyte scintigraphy for suspected hip or knee prosthesis infection, the addition of a semiquantitative evaluation to the qualitative analysis of early and late images leads to a significant improvement in both specificity and accuracy.

【 授权许可】

Unknown