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Objectives: White blood cell scanning with Tc-99m-hexamethylpropylene amine oxime (HMPAO) has proven a sensitive and specific imaging method in the diagnosis of suspected prosthesis infection. The aim of this retrospective study was to evaluate the usefulness of SPECT/CT performed simultaneously using a hybrid imaging device of prosthesis infections. Materials and methods: Tc-99m-HMPAO scintigraphy was performed on 37 patients (11 men and 26 women; age range 38-84 years; mean age +/- SD, 65.7 +/- 5.6 years). Planar scans were acquired 2.4 and 24 hour after injection. SPECT/CT was obtained 4 h after injection, using a dual-head hybrid gama camera coupled with a low-power x-ray tube. In all patients, scintigraphic results were matched with the results of surgery, cultures and clinical follow-up. Results: Seventeen (45,9%) out of 37 patients had prosthesis infection and 20 (54,1%) out of 37 patients had non-infectious prosthesis pathologies with Tc-99m-HMPAO scintigraphy and SPECT/CT. The Tc-99m-HMPAO scintigraphy was true-positive for infection in 16 of 37 patients and true-negative in 20 of 37 patients. SPECT/CT provided an accurate anatomic localization of all positive foci. With regard to the final diagnosis, SPECT/CT added a significant clinical contribution in 22 of 37 patients (59,4%). Sensitivity, specificity, negative predictive value and positive predictive values were 100%, 59.1%, 100%, 62.5% in planar images with Tc-99m-HMPAO scintigraphy and 100%, 90.1%, 100%, 88.2% in the planar+SPECT/CT imaging, respectively. Discussion: Our results indicate that SPECT/CT performed using a hybrid device can improve imaging with Tc-99m-HMPAO scintigraphy in patients with suspected osteomyelitis by providing accurate anatomic localization and precise definition of the extent of infection. (C) 2019 Sociedad Espanola de Medicina Nuclear e Imagen Molecular. Published by Elsevier Espana, S.L.U. All rights reserved. C1 [Sengoz, T.; Yaylali, O.; Yuksel, D.; Uluyol, O.] Pamukkale Univ, Med Fac, Dept Nucl Med, Denizli, Turkey. [Demirkan, F.] Pamukkale Univ, Med Fac, Dept Orthoped, Denizli, Turkey. |
