Evaluation of Bone or Soft Tissue Infection with Tc-99m Hmpao White Blood Cell Scintigraphy: Semiquantitative Method

Abstract

Objective: Aim the aim of this study was to investigate semiquantitatively the diagnostic performance of Tc-99m hexamethypropylene amine oxime labeled white blood cell (Tc-99m HMPAO-WBC) scintigraphy in patients with suspected bone or soft tissue infections. Methods: Material and Method twenty one patients who applied to Nuclear Medicine Departmant (for suspected prosthesis infection, diabetic foot, bone infection, graft infection) were evaluated retrospectively. Tc-99m HMPAO WBC scintigraphy imaging were performed to all patients. Planar images were taken 1., 2., and 4. hours after injecting the labeled leukocytes. Evaluation of infection with Tc-99m HMPAO WBC scintigraphy was done semiquantitatively. Relative uptake was determined by setting the region of interest (ROI) of lesion area on the anterior view. Rectangular ROI was set on the against limb (nonlesion). The ratio of the average pixel count in the lesion (L) to that in the non-lesion (NL) (L/NL ratio) was calculated at 1., 2., and 4. hours images. Final diagnosis was based on histopathology, microbiologic assays, or clinical and imaging follow-up. Results: 0.55 and 1.55±0.74, 1.42±0.55, 1.40±0.55 in positive and control groups, respectively. Positive group revealed a statistically significant increase L/NL values in the data 3 hours images (p=0.002). However, no statistically significant was found between L/NL values in 3 hours imaging data in control group (p=0.223). All the data in the positive group found Zehra Pinar Koc1, Yasemin Bulut2, Sinan Canpolat3, Ayhan Uysal4, Mehmet Sarac5 1Firat University Faculty of Medicine, Department of Nuclear Medicine, Elazig, Turkey 2Firat University Faculty of Medicine, Department of Clinic Microbiology, Elazig, Turkey 3Firat University Faculty of Medicine, Department of Phsiology, Elazig, Turkey 4Firat University Faculty of Medicine, Department of Cardiovascular Surgery, Elazig, Turkey 5Firat University Faculty of Medicine, Department of Pediatric Surgery, Elazig, Turkey Evaluation of Pulmonary Infection in Rabbits by Tc-99m Hmpao Labeled Leukocyte Scintigraphy