Imaging Osteomyelitis With Tc-99m-Labeled Antigranulocyte Antibody Fab′ Fragments

• Published in: Clinical nuclear medicine 2003-08, Vol.28 (8), p.643-647
• Main Authors: von Rothenburg, Thomas, Schaffstein, Josef, Ludwig, Jörn, Vehling, Dirk, Köster, Odo, Schmid, Gebhard
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Biological and medical sciences; Female; Humans; Male; Medical sciences; Middle Aged; Osteomyelitis - diagnosis; Osteomyelitis - diagnostic imaging; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Technetium
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/01.RLU.0000079387.59160.00

PURPOSEThe purpose of this study was to evaluate the diagnostic value of Tc-99m-labeled antigranulocyte antibody fragments in the diagnosis of osteomyelitis. MATERIALS AND METHODSThirty immunoscintigrams were evaluated retrospectively with 740 MBq (20 mCi) Tc-99m-labeled antigranulocyte antibodies. The final diagnoses were confirmed by histology, magnetic resonance imaging, computed tomography, and clinical follow-up. RESULTSIn the retrospective analysis, 20 of 30 patients (67%) demonstrated a true-positive result. Three of 30 patients (10%) had a false-positive result. A false-negative result was found in a diabetic patient with a perforating ulcer of the foot. Six of 30 patients had a true-negative result. A high sensitivity of 95%, a relatively high specificity of 67%, and a high diagnostic accuracy of 86% were present in this study. CONCLUSIONTc-99m labeled monoclonal antibody–Fab′ fragments are suitable for the detection of osteomyelitis. Its clinical application is simple. Its use guarantees a reliable and accurate diagnostic result just 1 to 2 hours after injection, making a late scan unnecessary. Coxarthrosis or hyperostosis can lead to false-positive results. A perforating ulcer of the foot may result in a false-negative conclusion.