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Leukoscan for orthopaedic imaging in clinical practice
1Department of Nuclear Medicine, Medway Maritime Hospital, Windmill Road, Gillingham, Kent ME7 5NY, UK. Paul.Ryan@medway-tr.sthames.nhs.uk
Nuclear Medicine Communications
|July 19, 2002
Summary
Leukoscan imaging using 99mTc antigranulocyte antibody Fab' fragments effectively images orthopaedic infections. The technique shows high negative predictive accuracy, making it valuable for ruling out infection in patients.
Area of Science:
- Nuclear Medicine
- Orthopaedic Surgery
- Infectious Disease Imaging
Background:
- Orthopaedic infections pose diagnostic challenges.
- 99mTc antigranulocyte antibody Fab' fragments (Leukoscan) show promise for infection imaging.
Purpose of the Study:
- To evaluate the clinical utility of Leukoscan for diagnosing orthopaedic infections in a UK setting.
- To assess the diagnostic performance of Leukoscan compared to clinical information.
Main Methods:
- Retrospective review of 55 patients undergoing three-phase bone scintigraphy and Leukoscan imaging.
- Leukoscan imaging performed 2 and 6 hours post-injection of 99mTc Leukoscan.
- Comparison of imaging results with available clinical information in 47 patients.
Main Results:
- Leukoscan demonstrated a sensitivity of 85% and specificity of 77%.
- Positive predictive accuracy was 58%, while negative predictive accuracy was high at 93%.
- 11 true positives, 26 true negatives, 8 false positives, and 2 false negatives were recorded.
Conclusions:
- Leukoscan is a viable imaging technique for orthopaedic infections.
- The high negative predictive accuracy is a key strength, useful for excluding infection.
- Positive Leukoscan findings may necessitate further correlative imaging for definitive diagnosis.