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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Rivista di Medicina Nucleare e Imaging Molecolare


A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2017 May 03

DOI: 10.23736/S1824-4785.17.02964-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Estimation of the added value of 99mTc-HMPAO labelled white blood cells scintigraphy for the diagnosis of infectious foci

Cécile MALHERBE 1, 2, 3, Anne-Claire DUPONT 1, 2, 3, Serge MAIA 1, 3, Yann VENEL 4, Benoit ERRA 4, Maria-Joao SANTIAGO-RIBEIRO 2, 3, 4, Nicolas ARLICOT 1, 2, 3

1 CHRU de Tours, Service de Radiopharmacie, Tours, France; 2 Université François Rabelais de Tours, Tours, France; 3 Inserm, UMR U930, Imagerie et Cerveau, Equipe 3, Imagerie Moléculaire du Cerveau, Tours, France; 4 CHRU Tours, Service de Médecine Nucléaire, Tours, France


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BACKGROUND: Leucocytes Scintigraphy (LS) is an in vivo imaging technique investigating infectious foci, performed in our nuclear medicine department after a 99mTc-Bisphophonates Bone Scintigraphy (BS) or an 18F-FDG-PET, in osteoarticular or vascular localisations, respectively. The aim of this study was to reassert the relevance of LS in the diagnostic of occult infections and its impact in therapeutic management.
METHODS: A 45-months retrospective study (2012-2015), including 34 patients, was conducted. Patients who underwent LS were identified and classified according to the location of the suspected infection and the feature of first-line imaging exploration. The final diagnosis (infected or not-infect lesion) was established regarding patients’ follow- up care, including clinical, biological biomarkers and therapeutic interventions. Sensitivity and specificity were calculated for each imaging modality.
RESULTS: LS were conducted for exploration of joint prosthesis(14), vascular prosthesis(7), bone infection or osteitis(8), algoneurodystrophia(2), symphisis infection(1), acute infection on chronicle inflammation(1) and cancer(1). All patients underwent a previous imaging exploration: BS (20 cases–59%), 18FDG-PET (10 cases- 29%), or another exploration (4 cases–12%). The sensitivity and specificity of BS were 67% and 36%, respectively, and 100% and 50% for 18FDG-PET, evidencing the lack of specificity of these approaches. Fourteen LS were positive (41%), with sensitivity, specificity and diagnostic accuracy of 85%, 86% and 85%, respectively.
CONCLUSIONS: Despite a long, delicate, and costly radiopharmaceutical and nuclear imaging process, the high specificity of LS supports its qualitative added value in the diagnosis of infectious foci, by improving clinical and therapeutic patient’s outcomes.


KEY WORDS: Leukocytes scintigraphy - Bone scintigraphy - 18 FDG/PET - Infection - Nuclear medicine

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Malherbe C, Dupont AC, Maia S, Venel Y, Erra B, Santiago-Ribeiro MJ, et al. Estimation of the added value of 99mTc-HMPAO labelled white blood cells scintigraphy for the diagnosis of infectious foci. Q J Nucl Med Mol Imaging 2017 May 03. DOI: 10.23736/S1824-4785.17.02964-8 

Corresponding author e-mail

cecile.malherbe@etu.univ-tours.fr