Cold–Hot Mismatch Between Tc-99m HMPAO–Labeled Leukocytes and Tc-99m Ciprofloxacin in Axial Skeleton Infections: A Report of Three Cases

Radiolabeled leukocyte scintigraphy is a well-established technique for the diagnosis of inflammation and infection with a typical presentation of a hot spot within the abnormal areas. However, in some cases of osteomyelitis of the axial skeleton, a cold defect pattern has been described. Tc-99m cip...

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Bibliographic Details
Published in:Clinical nuclear medicine 1999-11, Vol.24 (11), p.855-855
Main Authors: AMARAL, HORACIO, MORALES, BARBARA, PRUZZO, ROSSANA, BRITTON, KEITH E
Format: Article
Language:English
Subjects:
Adult
Anti-Infective Agents
Biological and medical sciences
Ciprofloxacin
Contrast media. Radiopharmaceuticals
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Leukocytes
Male
Medical sciences
Middle Aged
Miscellaneous. Technology
Osteomyelitis - diagnostic imaging
Pharmacology. Drug treatments
Radionuclide Imaging
Radionuclide investigations
Radiopharmaceuticals
Technetium
Technetium Tc 99m Exametazime
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Summary:Radiolabeled leukocyte scintigraphy is a well-established technique for the diagnosis of inflammation and infection with a typical presentation of a hot spot within the abnormal areas. However, in some cases of osteomyelitis of the axial skeleton, a cold defect pattern has been described. Tc-99m ciprofloxacin is a new agent claimed to be specific for imaging sites containing viable bacteria. In this report, we present three cases of proved bacterial infection of the axial skeleton with a mismatch pattern between Tc-99m ciprofloxin and tagged leukocytes. Although Tc-99m–labeled leukocyte scanning showed a cold defect, probably caused by bone marrow replacement, the Tc-99m ciprofloxacin consecutively revealed a hot spot at the site of infection. These data suggest that Tc-99m ciprofloxacin should be a better agent than radiolabeled leukocytes for detecting osteomyelitis of the axial skeleton.
ISSN:0363-9762
1536-0229
DOI:10.1097/00003072-199911000-00007