Improved method for detecting knee replacement infections based on extended combined 99mTc-white blood cell/bone imaging
| Autor: | M J Larikka, M M Hämäläinen, J A Junila, Aapo Ahonen, H P Syrjälä, O Niemelä |
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| Rok vydání: | 2001 |
| Předmět: |
Male
Pathology medicine.medical_specialty Prosthesis-Related Infections medicine.medical_treatment chemistry.chemical_element Knee replacement Bone imaging Technetium Scintigraphy Prosthesis Technetium Tc 99m Exametazime White blood cell medicine Leukocytes Humans Radiology Nuclear Medicine and imaging Arthroplasty Replacement Knee Radionuclide Imaging Aged Aged 80 and over medicine.diagnostic_test business.industry Soft tissue General Medicine Middle Aged medicine.anatomical_structure chemistry Female Radiopharmaceuticals Nuclear medicine business Complication |
| Zdroj: | Nuclear medicine communications. 22(10) |
| ISSN: | 0143-3636 |
| Popis: | The purpose of this study was to evaluate whether an extension of the imaging time to 24 h post-injection improves the diagnostic accuracy of technetium-99m-hexamethylpropyleneamine oxime (99mTc-HMPAO) leucocyte imaging in detecting knee replacement infections. Thirty patients were studied, with infection confirmed in eight (27%) and excluded in 22 on the basis of clinical and microbiological findings. Leucocyte imaging was carried out at 2-4 h (routine images) and at 24 h (late images) post-injection. For comparison, bone imaging with technetium-99m-hydroxydiphosphonate (99mTc-HDP) was carried out at arterial, soft tissue and metabolic phases. Late leucocyte imaging was found to be more sensitive (100% vs. 87.5%) and more specific (82% vs. 77%) than routine leucocyte imaging in detecting infections. All the bone imaging methods showed a sensitivity of 100%, whereas the specificity varied from only 5% to 23%. All procedures had high negative predictive values (NPVs) (94 to 100%) for excluding infection. However, the positive predictive value (PPV) was only 28 to 32% for bone imaging and 58% for routine leucocyte imaging, whereas late leucocyte imaging showed a PPV of 67% and a diagnostic accuracy of 87%. The data indicate that late leucocyte imaging may be superior to routine leucocyte imaging for examining patients with symptomatic knee replacements. |
| Databáze: | OpenAIRE |
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