The computer-generated bone marrow subtraction image: a valuable adjunct to combined In-111 WBC/Tc-99m in sulfur colloid scintigraphy for musculoskeletal infection

Clin Nucl Med. 1994 Mar;19(3):188-93.

Abstract

In-111 WBC scintigraphy supplemented by visual comparison with concurrent Tc-99m SC bone marrow imaging is used to identify infection within the marrow-containing skeleton. This retrospective study demonstrates the value of the computer-generated WBC/SC bone marrow subtraction image. Thirty-one patients with various conditions (postsurgery with or without orthopedic hardware, bacteremia with persistent fever, joint arthroplasty, and miscellaneous) underwent combined WBC/SC with bone marrow subtraction imaging. Infection was present in 21 of 36 possible sites (14 osseous, 7 soft tissue; 8 acute, 13 chronic). The bone marrow subtraction image identified two of these sites, which were not appreciated by visual inspection. The sensitivity, specificity, and accuracy for bone marrow subtraction were 95%, 93%, and 94%, respectively, as compared to 86%, 93%, and 89%, respectively, for the visual assessment of WBC and SC images. Computer-assisted subtraction imaging improves overall accuracy and enhances diagnostic certainty of combined WBC/SC scintigraphy for infection in the marrow-containing skeleton.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Bacterial Infections / diagnostic imaging*
  • Bacterial Infections / epidemiology
  • Bone Diseases / diagnostic imaging*
  • Bone Diseases / epidemiology
  • Bone Marrow / diagnostic imaging*
  • Child
  • Female
  • Humans
  • Image Processing, Computer-Assisted*
  • Indium Radioisotopes*
  • Leukocytes*
  • Male
  • Muscular Diseases / diagnostic imaging*
  • Muscular Diseases / epidemiology
  • Radionuclide Imaging
  • Retrospective Studies
  • Sensitivity and Specificity
  • Subtraction Technique
  • Surgical Wound Infection / diagnostic imaging*
  • Surgical Wound Infection / epidemiology
  • Technetium Tc 99m Sulfur Colloid*

Substances

  • Indium Radioisotopes
  • Technetium Tc 99m Sulfur Colloid