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Diagnostic accuracy of $^{99m}$Tc-antigranulocyte SPECT/CT in patients with osteomyelitis and orthopaedic device-related infections: A retrospective analysis


Plate, A; Weichselbaumer, V; Schüpbach, R; Fucentese, S F; Berli, M; Hüllner, M; Achermann, Y (2020). Diagnostic accuracy of $^{99m}$Tc-antigranulocyte SPECT/CT in patients with osteomyelitis and orthopaedic device-related infections: A retrospective analysis. International Journal of Infectious Diseases, 91:79-86.

Abstract

OBJECTIVES
Conventional imaging techniques are routinely used in the diagnostic work-up of patients with suspected osteomyelitis or orthopaedic implant-associated infections. Hybrid nuclear medicine imaging techniques are a suitable alternative to routine imaging modalities as they provide anatomical and functional information within one procedure. Our study investigated the performance of anti-granulocyte SPECT/CT using $^{99m}$Tc-labelled monoclonal antibodies in the diagnosis of osteomyelitis and orthopaedic implant-associated infections.
METHODS
In this retrospective analysis, we included all patients with $^{99m}$Tc-antigranulocyte SPECT/CT acquired in the context of a suspected bone and joint infection. All patients underwent routine diagnostics and/or had a clinical follow-up of at least 12 months.
RESULTS
26 episodes were included. Fifteen exams were performed for suspected osteomyelitis, and 11 for suspected orthopaedic implant-associated infection. SPECT/CT was ordered most often if standard diagnostic tests or conventional imaging modalities remained inconclusive. The overall sensitivity and specificity for the diagnosis of an infection was 77.8% and 94.1%, respectively. The positive predictive value was 87.5% and the negative predictive value 88.9%. Diagnostic accuracy was 88.5%.
CONCLUSIONS
$^{99m}$Tc-antigranulocyte SPECT/CT imaging has a high accuracy in the diagnosis of osteomyelitis and orthopaedic implant-associated infections and is a suitable non-invasive diagnostic tool if standard diagnostic examinations are inconclusive or not applicable.

Abstract

OBJECTIVES
Conventional imaging techniques are routinely used in the diagnostic work-up of patients with suspected osteomyelitis or orthopaedic implant-associated infections. Hybrid nuclear medicine imaging techniques are a suitable alternative to routine imaging modalities as they provide anatomical and functional information within one procedure. Our study investigated the performance of anti-granulocyte SPECT/CT using $^{99m}$Tc-labelled monoclonal antibodies in the diagnosis of osteomyelitis and orthopaedic implant-associated infections.
METHODS
In this retrospective analysis, we included all patients with $^{99m}$Tc-antigranulocyte SPECT/CT acquired in the context of a suspected bone and joint infection. All patients underwent routine diagnostics and/or had a clinical follow-up of at least 12 months.
RESULTS
26 episodes were included. Fifteen exams were performed for suspected osteomyelitis, and 11 for suspected orthopaedic implant-associated infection. SPECT/CT was ordered most often if standard diagnostic tests or conventional imaging modalities remained inconclusive. The overall sensitivity and specificity for the diagnosis of an infection was 77.8% and 94.1%, respectively. The positive predictive value was 87.5% and the negative predictive value 88.9%. Diagnostic accuracy was 88.5%.
CONCLUSIONS
$^{99m}$Tc-antigranulocyte SPECT/CT imaging has a high accuracy in the diagnosis of osteomyelitis and orthopaedic implant-associated infections and is a suitable non-invasive diagnostic tool if standard diagnostic examinations are inconclusive or not applicable.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Microbiology (medical)
Health Sciences > Infectious Diseases
Language:English
Date:1 February 2020
Deposited On:13 Jan 2020 10:05
Last Modified:22 Apr 2020 21:47
Publisher:Elsevier
ISSN:1201-9712
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.ijid.2019.11.017
PubMed ID:31759168

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