title: Imaging osteomyelitis with Tc-99m-labeled antigranulocyte antibody Fab' fragments.
abstract: PURPOSE The purpose of this study was to evaluate the diagnostic value of Tc-99m-labeled antigranulocyte antibody fragments in the diagnosis of osteomyelitis. MATERIALS AND METHODS Thirty immunoscintigrams were evaluated retrospectively with 740 MBq (20 mCi) Tc-99m-labeled antigranulocyte antibodies. The final diagnoses were confirmed by histology, magnetic resonance imaging, computed tomography, and clinical follow-up. RESULTS In the retrospective analysis, 20 of 30 patients (67%) demonstrated a true-positive result. Three of 30 patients (10%) had a false-positive result. A false-negative result was found in a diabetic patient with a perforating ulcer of the foot. Six of 30 patients had a true-negative result. A high sensitivity of 95%, a relatively high specificity of 67%, and a high diagnostic accuracy of 86% were present in this study. CONCLUSION Tc-99m labeled monoclonal antibody-Fab' fragments are suitable for the detection of osteomyelitis. Its clinical application is simple. Its use guarantees a reliable and accurate diagnostic result just 1 to 2 hours after injection, making a late scan unnecessary. Coxarthrosis or hyperostosis can lead to false-positive results. A perforating ulcer of the foot may result in a false-negative conclusion.
authors.affiliation: St. Josef Hospital-University Hospital, Department of Radiology and Nuclear Medicine, Germany. thomas.rothenburg@t-online.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Von Rothenburg
authors.forename: Josef
authors.initials: J
authors.lastname: Schaffstein
authors.forename: Jörn
authors.initials: J
authors.lastname: Ludwig
authors.forename: Dirk
authors.initials: D
authors.lastname: Vehling
authors.forename: Odo
authors.initials: O
authors.lastname: Köster
authors.forename: Gebhard
authors.initials: G
authors.lastname: Schmid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013667:Technetium
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D019275:Radiopharmaceuticals; C101172:Sulesomab; D013667:Technetium