Comparison between 67-gallium citrate of exametazine-T-99m labelled leucocites and the DTPA-indio-111 labelled G immunoglobuline in the diagnosis of bone and articular infections

The aim of this study was to compare the ability of 67-Gallium citrate (67Ga), 99m-Tc labelled leucocytes (99mTc-WBC) and 111-In-labelled immunoglobulin G (111In-IgG) scintigraphy in bone and joint infections diagnosis. Fifty-six patients were studied. For all patients a bone scan using 99mTc-MDP was indicated. The patients were randomized allocated for 67Ga (Group 1 - 22 patients) or simultaneous administration 99mTc-labelled leucocytes and 111In-IgG.(Group 2 - 34 patients) study. For the groups 1 and 2 were confirmed respectively 12/26 y 11/34 septic lesions. The 67Ga scintigraphy showed 6 true-positive, 9 true-negative, 5 false-positive and 6 false-negative. With 99mTc-WBC, the respective values were 8, 18, 5 and 3. With 111In-IgG, the figures were 7, 17, 6 and 4, respectively. The sensitivity, specificity and accuracy were 50%, 64,3% and 57,7% respectively for the 67Ga, 72,7%, 78,2% and 76,4% respectively for 99mTc-WBC and 63,6%, 73,9% and 70,6% respectively for 111In-IgG. In this study, the labelled leucocytes scintigraphy showed more accurate than 67Ga and 111In-IgG scans for the diagnosis of bone and joint infections. However, the obtained results were less reliable for the diagnosis of occult sepsis in the patients with joint prosthesis (Au)