title: 99mTc-HMPAO labelled white blood cell scintigraphy in patients with osteoarticular infection: the value of late images for diagnostic accuracy and interobserver reproducibility.
abstract: 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.
authors.affiliation: Service de Médecine Nucléaire, CHRU Bordeaux, Hôpital Pellegrin, Place Amélie Raba-Léon, 33076, Bordeaux Cédex, France. philippe.fernandez@u-bordeaux2.fr
authors.forename: P
authors.initials: P
authors.lastname: Fernandez
authors.forename: A
authors.initials: A
authors.lastname: Monet
authors.forename: C
authors.initials: C
authors.lastname: Matei
authors.forename: H
authors.initials: H
authors.lastname: De Clermont
authors.forename: M
authors.initials: M
authors.lastname: Guyot
authors.forename: R
authors.initials: R
authors.lastname: Jeandot
authors.forename: H
authors.initials: H
authors.lastname: Dutronc
authors.forename: C
authors.initials: C
authors.lastname: Dumoulin
authors.forename: M
authors.initials: M
authors.lastname: Dupon
authors.forename: D
authors.initials: D
authors.lastname: Ducassou
mesh_terms: 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*
chemical_list: D019690:Technetium Tc 99m Exametazime