Role Of Tc99m-Besilesomab Scan With The Added Benefit Of Single Photon Emission Computed Tomography/ Computed Tomography (Spect/Ct) In Localising Infection
Loading...
Date
2017
Authors
Mohamed Aslum Khan, Farahnaz
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Aim: The aim of the study is to localise site of infection using Tc99m-besilesomab scan and to assess the additional contributions of SPECT/CT over planar scan in patients.
Material and Methods: Planar and SPECT/CT Tc99m-besilesomab scan were prospectively performed in 23 patients (8 males and 15 females) with suspected infection and the data were analysed. In all patients Tc99m-besilesomab imaging findings were correlated with the results of blood cultures, tissue cultures and final diagnosis as the reference standards. Twenty three patients underwent planar and SPECT/CT imaging (13 with unknown site of infection and 10 with suspected osteomyelitis). Both cold and hot spots were considered diagnostic. SPECT/CT contribution was recorded and the factors affecting the scan were analysed. The impact of SPECT/CT on patient management was assessed.
Results: Tc99m-besilesomab scan managed to detect infection with high sensitivity of 88% and specificity of 83%. The agreement that was obtained between the presence of infection and the ability of Tc99m-besilesomab imaging to detect infection was significant with a kappa agreement of 0.7 (p<0.05). The addition of SPECT/CT has increased the sensitivity by 6% and specificity by 17%. Sixteen out of 23 patients had true positive
Tc99m-besilesomab SPECT/CT study. Six patients had true negative and only one patient had false negative study. SPECT/CT changed the management in one patient which was missed by planar imaging and also provided additional information for detection of infection as compared to planar imaging by providing accurate anatomical localization in all true positive foci.
Conclusion: Tc99m-besilesomab scan is useful in cases of unknown infection and has a high sensitivity and specificity. The addition of SPECT/CT increased the sensitivity of detecting focus of infection from 88% to 94% and specificity from 83% to 100%. SPECT/CT also provided extra information to the exact anatomical location and the extent of involvement of the disease as compared to planar imaging alone.
Key Words: SPECT/CT; Osteomyelitis; besilesomab scan; Scintimun scan; PUO
Description
Keywords
To localise site of infection using , Tc99m-besilesomab scan.