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[Tc-99m ciprofloxacin in clinically selected patients for peripheral osteomyelitis, spondylodiscitis and fever of unknown origin--preliminary results].

AbstractAIM:
Retrospective evaluation of Tc-99m ciprofloxacin (infection) scintigraphy consecutively performed in a series of patients clinically suspected for peripheral osteomyelitis (OM), spondylodiscitis (SD) and fever of unknown origin (FUO).
METHODS:
A total of 20 patients clinically suspected for OM (n = 12), SD (n = 3) and FUO (n = 5) were included in our retrospective analysis. The additional criterion was a positive 3-phase bone scan for OM, or a 2-phase bone scan in case of SD. Planar whole body scans and static acquisitions were performed 1 and 4 h after application of 370 MBq Tc-99m ciprofloxacin. In 10 patients with suspected OM, additional immunoscintigraphy using Tc-99m labelled monoclonal antibodies (Mab BW 250/183) was performed and the correlation of infection to bloodpool and antigranulocyte scintigraphy was analysed.
RESULTS:
OM: Bacterial infection was confirmed in 8 of 15 lesions. Infection demonstrated true positive (TP) results in 7 of 8, true negative (TN) results in 2 of 7, false positive (FP) results in 5 of 7 patients and one false negative (FN) result. A strong correlation could be demonstrated between T/NT ratios of infection and bloodpool Tc-99m medronate imaging (r = 0.84, 0.88) and between infection and BW 250/183 (r = 0.92, 0.90). Using a threshold of 2.0 for T/NT ratio, only TP results could be observed whereas a T/NT in the range of 1.0-2.0 could not discriminate between septic and aseptic inflammation. Concordant results with Mab BW 250/183 could only be observed in 5 of 10 patients (4 TP, 1 TN) by showing 4 FP and 1 FN lesions with IF.
CONCLUSION:
Non-specific uptake of infection can be observed in a variety of clinical situations with moderate uptake, by showing a strong correlation with blood-pool imaging. Nevertheless, intense uptake may be specific for septic inflammation.
AuthorsH J Gallowitsch, M Heinisch, P Mikosch, E Kresnik, G Kumnig, I Gomez, P Lind
JournalNuklearmedizin. Nuclear medicine (Nuklearmedizin) Vol. 41 Issue 1 Pg. 30-6 (Feb 2002) ISSN: 0029-5566 [Print] Germany
Vernacular TitleTc-99m-Ciprofloxacin bei Verdacht auf periphere Osteomyelitis, Spondylodiszitis und Fieber unklarer Genese in einem klinisch selektierten Patientengut--vorläufige Ergebnisse.
PMID11917346 (Publication Type: Journal Article)
Chemical References
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Technetium Tc 99m ciprofloxacin
  • Ciprofloxacin
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Infections (diagnostic imaging)
  • Bone and Bones (diagnostic imaging)
  • Ciprofloxacin (analogs & derivatives)
  • Diagnosis, Differential
  • Discitis (diagnostic imaging)
  • Female
  • Fever of Unknown Origin (diagnostic imaging)
  • Humans
  • Male
  • Middle Aged
  • Organotechnetium Compounds
  • Osteomyelitis (diagnostic imaging)
  • Radioimmunodetection
  • Radiopharmaceuticals

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