99mTc-HMPAO labelled white blood cell scintigraphy in patients with osteoarticular infection: the value of late images for diagnostic accuracy and interobserver reproducibility

Eur J Clin Microbiol Infect Dis. 2008 Dec;27(12):1239-44. doi: 10.1007/s10096-008-0563-x. Epub 2008 Jun 27.

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.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Leukocytes / diagnostic imaging*
  • Leukocytes / metabolism*
  • Male
  • Middle Aged
  • Observer Variation
  • Osteoarthritis / diagnosis*
  • Predictive Value of Tests
  • Prospective Studies
  • Radionuclide Imaging / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Technetium Tc 99m Exametazime / metabolism*

Substances

  • Technetium Tc 99m Exametazime