RT Journal Article SR Electronic T1 Inability of 99mTc-Ciprofloxacin Scintigraphy to Discriminate Between Septic and Sterile Osteoarticular Diseases JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 920 OP 926 VO 44 IS 6 A1 Sarda, Laure A1 Crémieux, Anne-Claude A1 Lebellec, Yves A1 Meulemans, Alain A1 Lebtahi, Rachida A1 Hayem, Gilles A1 Génin, Rémi A1 Delahaye, Nicolas A1 Huten, Denis A1 Le Guludec, Dominique YR 2003 UL http://jnm.snmjournals.org/content/44/6/920.abstract AB Ciprofloxacin labeled with 99mTc specifically binds to various bacteria. Thus, it potentially constitutes a specific marker allowing discrimination between septic arthritis/osteomyelitis and aseptic osteoarticular diseases. The aim of this prospective study was to evaluate such properties in patients with skeletal diseases. Methods: We prospectively investigated 2 groups of patients: patients with suspected osteoarticular infections (G1, n = 16) and a control group of patients with a presentation of osteoarticular diseases and no sign suggestive of infection (G2, n = 11). All had clinical, biologic, and radiologic evaluations and had 1-, 4-, and 24-h images from 99mTc-ciprofloxacin scintigraphy (370 MBq) before planned biopsy or surgery. For 23 patients, the scintigraphic results were compared with histologic and bacteriologic analyses of biopsy tissue samples; for 4 patients, the scintigraphic results were compared with the findings from 23 ± 5 mo of follow-up. Results: In G1, 99mTc-ciprofloxacin findings were true-positive in all 11 infected sites, true-negative in 2 cases, and false-positive in 3. In G2, 99mTc-ciprofloxacin was true-negative in 4 cases and false-positive in 7. Neither the location of 99mTc-ciprofloxacin activity nor its intensity or kinetics between 1, 4, and 24 h allowed discrimination between infection and aseptic diseases (sterile loosened joint replacement, pseudoarthrosis, or arthrosis). Sensitivity, specificity, and accuracy were 100%, 37.5%, and 63%. Conclusion: 99mTc-Ciprofloxacin scintigraphy showed good sensitivity and a high negative predictive value for the detection of bone and joint infection, but it did not discriminate between infected and aseptic osteoarticular diseases in symptomatic patients referred for surgery.