HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pelosi, E. Articles by Bisi, G. Search for Related Content PubMed PubMed Citation Articles by Pelosi, E. Articles by Bisi, G.

^99mTc-HMPAO-Leukocyte Scintigraphy in Patients with Symptomatic Total Hip or Knee Arthroplasty: Improved Diagnostic Accuracy by Means of Semiquantitative Evaluation

¹ Dottorato di Ricerca Radioimmunolocalizzazione dei Tumori Umani, Università di Torino, Torino, Italy
² Servizio di Medicina Nucleare, Università di Torino, Ospedale S. Giovanni Battista, Torino, Italy
³ Dipartimento di Sanità Pubblica e Microbiologia, Università di Torino, Ospedale S. Giovanni Battista, Torino, Italy
⁴ Divisione di Malattie Infettive, Università di Torino, Ospedale Amedeo di Savoia, Torino, Italy

The aim of this study was to evaluate the diagnostic value, in suspected infectious prostheses, of ^99mTc-labeled hexamethylpropyleneamine oxime (^99mTc-HMPAO) leukocyte scintigraphy interpreted with the addition of a semiquantitative analysis. Methods: By means of a retrospective review, we included a group of 78 consecutive patients with suspected hip or knee prosthesis infection. We performed 91 ^99mTc-HMPAO-leukocyte scintigraphies and examined 95 localizations that were suspect. Images were acquired at 3 different time points after the injection of the labeled leukocytes: 50 min (early images), 4 h, and 24 h (late images). The scintigraphic examinations were independently evaluated by 3 observers; qualitative and semiquantitative analyses were performed. The final diagnosis of infection was based on surgical, histologic, and bacteriologic data and follow-up. Results: On qualitative analysis, sensitivity, specificity, and accuracy were 80.4%–87%, 65.3%–71.4%, and 75.8%–77.9%, respectively. On semiquantitative analysis, sensitivity, specificity, and accuracy were 95.6%, 95.8%, and 95.8%, respectively. The analysis of 95% confidential intervals showed statistically significant differences in specificity and accuracy between semiquantitative and qualitative analyses. Conclusion: In those patients who underwent ^99mTc-HMPAO-leukocyte scintigraphy for suspected hip or knee prosthesis infection, the addition of a semiquantitative evaluation to the qualitative analysis of early and late images leads to a significant improvement in both specificity and accuracy.

Key Words: infection radionuclide imaging • hip prosthesis • knee prosthesis • ^99mTc-labeled leukocytes