Technetium-99-labeled leukocytes in diagnosing diabetic osteomyelitis in the foot.
Hexamethylpropylamineoxine (HMPAO)-labeled leukocytes were studied to examine the scintigraphic significance of the procedure in diagnosing bone infection in patients with chronic nonhealing foot ulcerations. Fifty-two patients were scanned with Technetium-99-labeled white blood cells and scintigraphic results were compared with histological analysis, bone culture, and radiographic findings. Twenty-one patients demonstrated positive uptake with imaging and focal accumulation of leukocytes at the area of suspected infection. Sensitivity, specificity, and accuracy were calculated and found to be 86%, 90%, and 88%, respectively. Thirty-one members of the population were also scanned with Tc-99 methylene diphosphate (MDP) triphasic scintigraphy. Sensitivity equaled 91% and specificity was found to be significantly lower (40%) when compared with the leukocyte-labeled scans. Technetium-99 (HMPAO) leukocyte scintigraphs demonstrated a significantly higher specificity and accuracy rate when compared with Technetium-99 (MDP) triphasic scans.
Harvey
J
J
Podiatry Service, Department of Veterans Affairs Medical Center, Miami, Florida, USA.
Cohen
M M
MM
D000368:Aged; D017719:Diabetic Foot / Q000150:complications* / Q000000981:diagnostic imaging; D005710:Gallium Radioisotopes; D006801:Humans; D007205:Indium Radioisotopes; D007553:Isotope Labeling; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000209:etiology; D010091:Oximes; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime
D005710:Gallium Radioisotopes; D007205:Indium Radioisotopes; D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime