Evaluation of technetium-99m ciprofloxacin (Infecton) in the imaging of infection.
BACKGROUND
The aim of this study was to evaluate the usefulness of technetium-99m (Tc-99m) ciprofloxacin in imaging inflammation/infection. The ciprofloxacin for labelling, as a kit, was obtained from St Bartholomew's Hospital in London.


METHODS
Patients were injected intravenously with Tc-99m ciprofloxacin and imaging was done at 10 minutes, 4 hours and 24 hours if necessary. Tomographic images (SPECT) were obtained in a few patients. Ninety-six patients were studied using Tc-99m ciprofloxacin. Forty-eight patients had bone scans and 22 had Tc-99m IgG scans. Eight patients were imaged using Tc-99m HMPAO labelled white blood cell, and bacteriological culture results were available in 24 patients. Organisms cultured included Acinetobacter baumanii, Streptococcus, Staphylococcus aureus, Pseudomonas, Klebsiella, Blastococidia, Methicillin-resistant S. aureus, Salmonella and Candida.


RESULTS
Findings were evaluated against microbiology, alternative imaging modalities and clinical outcome. There were 47 true positives, 33 true negatives, 5 false positives and 11 false negatives, giving a sensitivity of 81% and specificity of 87%. The positive and negative predictive values were 90% and 75%, respectively. There were no side effects and the scan was particularly useful in the evaluation of painful joint prosthesis to exclude infection. Repeat studies on 8 patients given antibiotics over a long period were very useful in deciding on termination of the antibiotic treatment.
Sundram
F X
FX
Department of Nuclear Medicine, Block 2 Basement 1, Singapore General Hospital, 1 Hospital Drive, Singapore 169608.
Wong
W Y
WY
Ang
E S
ES
Goh
A S
AS
Ng
D C
DC
Yu
S
S
D000038:Abscess / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000000981:diagnostic imaging*; D002939:Ciprofloxacin; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007553:Isotope Labeling; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging; D011014:Pneumonia / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013667:Technetium
D002939:Ciprofloxacin; D013667:Technetium