This retrospective study looked at the role of
indium 111-labeled white blood cell (111In WBC) scintigraphy in head and neck
infections. The efficacy of 111In WBCs was compared to
gallium 67 citrate (67Ga) and
technetium Tc99m
methylene diphosphonate (99mTc MDP) scintigraphy in detecting and monitoring the resolution of
infection. For 22 active
infections, the sensitivities for 111In WBC, 67Ga, and 99mTc MDP scintigraphy were 94%, 56%, and 86%, respectively, and the specificities for 111In WBC, 67Ga, and 99mTc MDP scintigraphy were 100%, 43%, and 0%, respectively. For 8 successfully treated
infections, all seven 111In WBC studies became negative after
therapy, in as short an interval as 1 month. In contrast, all seven 99mTc MDP images remained positive for as long
as 6 months after
therapy. The seven 67Ga studies had variable results, with four (57%) remaining positive, including two (28%) positive at 6 months after
therapy. These results suggest that 111In WBC scintigraphy should be the initial
radionuclide imaging tool in detecting active head and neck
infections because of its greater accuracy, and its ability to revert to normal much sooner than 67Ga or 99mTc MDP scintigraphs when applied to a subset of patients with resolved
infections.