title: The role of 99Tcm-HMPAO white cell imaging in suspected orthopaedic infection.
abstract: Accurate diagnosis is essential for the effective management of suspected bone infection. Current imaging techniques have had limited success and further work is required. Although white cell labelling techniques have been available for many years the radiopharmaceuticals employed have disadvantages, particularly in their availability and suitability for imaging. These problems have been overcome by the use of 99Tcm-HMPAO as an in vitro leukocyte labelling agent. The aims of this study were to assess retrospectively its role and accuracy in imaging orthopaedic infection and to compare the results with three-phase bone imaging. 30 patients with suspected bone infection underwent three-phase methylene diphosphonate (MDP) bone imaging and labelled leukocyte imaging on separate occasions. 16 bone scans were positive for infection, of which 14 were subsequently confirmed, and there were no false negatives. There were no false positive white cell studies and only one infection was not identified. 99Tcm-HMPAO white cell imaging has been shown to be an accurate technique for the diagnosis of bone infection but should be performed only following a positive finding on three-phase bone scanning, since the latter is highly sensitive but significantly less expensive, making it a more appropriate screening procedure.
authors.affiliation: Department of Medical Physics, County Hospital, Lincoln, UK.
authors.forename: C
authors.initials: C
authors.lastname: Copping
authors.forename: S M
authors.initials: SM
authors.lastname: Dalgliesh
authors.forename: N J
authors.initials: NJ
authors.lastname: Dudley
authors.forename: P A
authors.initials: PA
authors.lastname: Griffiths
authors.forename: M
authors.initials: M
authors.lastname: Harrington
authors.forename: R
authors.initials: R
authors.lastname: Potter
authors.forename: B D
authors.initials: BD
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis; D006801:Humans; D007239:Infections / Q000000981:diagnostic imaging*; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime