Radionuclide Imaging of Osteomyelitis
Section snippets
99mTc-Diphosphonates
Bone scintigraphy usually is performed with technetium-99m-methylene diphosphonate (99mTc-MDP). Uptake of this radiopharmaceutical, which binds to the hydroxyapatite crystal, depends on blood flow and rate of new bone formation. When osteomyelitis is the indication, a 3-phase bone scan usually is performed. Three-phase bone scintigraphy consists of a dynamic imaging sequence, the flow or perfusion phase, followed immediately by static images of the region of interest, the blood pool or soft
Indications
It is important to recognize that no single agent is equally efficacious in all regions of the skeleton. The selection of an appropriate study is governed by the clinical question posed. In adults, it is useful to divide musculoskeletal infections into 3 broad locations: spine, orthopedic hardware, and diabetic foot.
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PET-Computed Tomography in Bone and Joint Infections
2023, PET ClinicsCitation Excerpt :In all these areas, the role of molecular imaging techniques has been emphasized, like 3-phase bone scan and technetium-99m (99mTc)-labeled leukocytes, which have superior performance in the aforementioned drawbacks and have been extensively used in low probability OM diagnosis.5 Hybrid imaging with FDG-PET/CT gives added benefits and sensitivity and specificity of >90% in most studies2 when compared with 78% and 84% for combined bone and leukocyte scintigraphy and 84%and 60% for MRI, respectively.6,7 Recent metanalysis by Wang and colleagues8 suggested the superior sensitivity and specificity of PET/CT of >90%, bone scintigraphy (83% and 45%), and labeled-white blood cell (WBC) scintigraphy (74% and 88%), respectively.
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