title: Reliability of white blood cell scan in the follow-up of osteomyelitis.
abstract: BACKGROUND
  The question of whether antibiotic treatment does or does not affect reliability of white blood cell scan (WBCS) to detect disease activity in clinical practice is still unanswered. Our aim was to study the relationship between scintigraphic findings of WBCS and antibiotic therapy in a group of patients affected with osteomyelitis (OM).
  
  
  METHODS
  We retrospectively reviewed 57 scans, performed in 18 patients affected by OM and who were on antibiotic treatment. The number of therapy weeks was calculated for each antibiotic. A comparison of results obtained during and after discontinuation of the antibiotic treatment was made. Overall sensitivity, specificity and accuracy of WBCS were calculated and compared with those obtained in patients undergoing therapy.
  
  
  RESULTS
  Forty-seven scans were performed during treatment and 10 scans after discontinuation of treatment. The scintigraphic results obtained during and after discontinuation of treatment were as follows: TN 14 and 8, TP 31 and 2, FN 2 and 0, FP 0 and 0, respectively. Sensitivity, specificity and accuracy of WBCS, calculated in all patients, were 94.3%, 100% and 96.5% respectively. In patients receiving antibiotic therapy, the same parameters were 93.9%, 100% and 95.7% respectively. In patients treated with antibiotics that can decrease leukocyte function, there were 10 TN, 14 TP, 2 FN and 0 FP, while in patients treated with antibiotics that have not effect on leukocyte function there were 4 TN, 17 TP, 0 FN and 0 FP.
  
  
  CONCLUSIONS
  The reliability of WBCS in the detection of disease activity during antibiotic treatment does not change significantly. It can be assumed that the influence of antibiotic therapy on labelled leukocyte behaviour is negligible.
authors: Nuclear Medicine Unit, Department of Radiological Sciences, University of Rome La Sapienza, Rome, Italy.
authors: Mauro
authors: M
authors: Liberatore
authors: Enrico
authors: E
authors: Calandri
authors: Gian Luca
authors: GL
authors: Pavoni
authors: Pia
authors: P
authors: Baiocchi
authors: Anna Paola
authors: AP
authors: Iurilli
authors: Mario
authors: M
authors: Venditti
authors: Adil
authors: A
authors: Al-Nahhas
authors: Domenico
authors: D
authors: Rubello
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents