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Tc-99m Labeled HMPAO white Blood Cell Scintigraphy in Pediatric Patients
Funda Aydın1, Arzu Kın Cengiz, Fırat Güngör
1Akdeniz University Medical School, Department of Nuclear Medicine, Antalya, Turkey.
Insights
Technetium-99m hexamethylpropylene amine oxime (HMPAO) labeled white blood cell (WBC) scintigraphy is a valuable tool for diagnosing pediatric infections. This study confirms its accuracy in detecting bone infections and appendicitis.
Area of Science:
- Nuclear Medicine
- Pediatric Imaging
- Infectious Disease Diagnosis
Background:
- White blood cell (WBC) scintigraphy using (99m)Tc-HMPAO is a common diagnostic method for acute infections in children.
- It is utilized for identifying infection/inflammation in fever of unknown origin, osteomyelitis, and suspected appendicitis.
Purpose of the Study:
- To retrospectively evaluate the diagnostic utility of (99m)Tc-HMPAO labeled WBC scintigraphy in pediatric patients.
- To assess its effectiveness in diagnosing bone infections, fever of unknown origin, and acute appendicitis.
Main Methods:
- Retrospective analysis of 13 pediatric patients (5 boys, 8 girls; mean age 6.9±6.2 years) between January 2006 and December 2008.
- Patients presented with suspected bone infection (n=7), fever of unknown origin (n=3), or suspected acute appendicitis (n=3).
- (99m)Tc-HMPAO labeled WBC scintigraphy was performed on all patients, with diagnoses confirmed by surgical/pathological results or clinical follow-up.
Main Results:
- The scintigraphy demonstrated high accuracy with 6 true positive and 6 true negative cases.
- One case of fever of unknown origin was a false negative, later diagnosed as encephalitis via MRI.
- Overall, the method showed significant diagnostic value.
Conclusions:
- Leukocyte scintigraphy is a useful diagnostic tool for suspected bone infection, fever of unknown origin, and acute appendicitis in pediatric patients.
- (99m)Tc-HMPAO labeled WBC scintigraphy is a rapid and accurate method for detecting these conditions.
- The study supports the reliable use of WBC scintigraphy in the pediatric population for these specific diagnoses.
Objective:
(99m)Tc labeled hexamethylpropylene amine oxime (HMPAO) white blood cell (WBC) scintigraphy is a frequently used option for acute infection, particularly in pediatric patients. This scintigraphy is applied to detect sites of infection/inflammation in patients with fever of unknown origin, to find and follow up osteomyelitis, and to detect suspicion of acute appendicitis. The aim of this retrospective study was to evaluate the value of (99m)Tc-HMPAO labeled WBC scintigraphy in pediatric patients.
Material And Methods:
The study was conducted between January 2006 and December 2008 and included 13 patients (5 boys, 8 girls; mean age 6.9±6.2 years). Those patients who had suspicion of bone infection (n=7), fever of unknown origin (n=3), and suspicion of acute appendicitis (n=3) were evaluated retrospectively. (99m)Tc-HMPAO labeled WBC scintigraphy imaging was performed to all patients. Diagnosis was done according to operation and pathological results or clinical follow-up.
Results:
(99m)Tc-HMPAO labeled WBC scintigraphy has been found to be true positive in 6 cases, true negative in 6 cases, and false negative in one patient who had fewer unknown origin. The false negative case has been found to have encephalitis with MRI.
Conclusion:
Leukocyte scintigraphy has been described as a useful diagnostic tool in the diagnosis of suspicion of bone infection, fever of unknown origin and suspicion of acute appendicitis. (99m)Tc-HMPAO labeled WBC scintigraphy is a rapid and very accurate method for detecting those pathologies. Our results showed that WBC scintigraphy might be reliably used for diagnosis of suspected bone infection and acute appendicitis, fever of unknown origin, and acute appendicitis, in pediatric patient population.
Conflict Of Interest:
None declared.
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