99mTc-HMPAO labelled white blood cell scintigraphy in patients with osteoarticular infection: the value of late images for diagnostic accuracy and interobserver reproducibility.
The objectives of this study were to evaluate the diagnostic value of 99mTc-HMPAO labelled white blood cell scintigraphy (WBCS) in patients with suspected osteomyelitis using late images and to study interobserver reproducibility. This study prospectively included 120 patients, and after a follow-up of one year, only 70 patients (n = 49 with implants, n = 21 without implants) were selected. The final diagnosis of infection was based either on microbiological data (n = 54) or follow-up (n = 16). We performed WBCS with 4 h and 24 h scans. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 77%, 72%, 83%, 64%, and 75% at 4 h, and 74%, 87%, 91%, 59%, and 79% at 24 h, respectively. The interobserver reproducibility shows a 63% prevalence of agreement between results (kappa = 0.5) at 4 h and 80% (kappa = 0.74) at 24 h, respectively. WBCS with 24-h images improves specificity and interobserver reproducibility in patients with suspected osteoarticular sepsis.
Fernandez
P
P
Service de Médecine Nucléaire, CHRU Bordeaux, Hôpital Pellegrin, Place Amélie Raba-Léon, 33076, Bordeaux Cédex, France. philippe.fernandez@u-bordeaux2.fr
Monet
A
A
Matei
C
C
De Clermont
H
H
Guyot
M
M
Jeandot
R
R
Dutronc
H
H
Dumoulin
C
C
Dupon
M
M
Ducassou
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010003:Osteoarthritis / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011877:Radionuclide Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime / Q000378:metabolism*
D019690:Technetium Tc 99m Exametazime