| Title: |
Handling of Doubtful WBC Scintigraphies in Patients with Suspected Prosthetic Joint Infections |
| Authors: |
Chiara Lauri; Giancarlo Lauretti; Filippo Galli; Giuseppe Campagna; Simone Tetti; Donatella Riolo; Alberto Signore |
| Contributors: |
Lauri, Chiara; Lauretti, Giancarlo; Galli, Filippo; Campagna, Giuseppe; Tetti, Simone; Riolo, Donatella; Signore, Alberto |
| Publisher Information: |
MDPI |
| Publication Year: |
2020 |
| Collection: |
Sapienza Università di Roma: CINECA IRIS |
| Subject Terms: |
wbc scintigraphy; qualitative analysi; semi-quantitative analysi; bms |
| Description: |
Despite the application of EANM recommendations for radiolabelled white-blood-cells (WBC) scintigraphy, some cases still remain doubtful based only on visual analysis. The aim of this study was to investigate the role of semi-quantitative analysis and bone marrow scan (BMS) in solving doubtful cases. We retrospectively evaluated all [99mTc]HMPAO-WBC scintigraphies performed, in the last 7 years, for a suspected monolateral prosthetic joint infection (PJI). In doubtful cases, we used five different thresholds of increase of target-to-background (T/B) ratio, between delayed and late images, as criteria of positivity (5%, 10%, 15%, 20% and 30%). BMS were also analysed and sensitivity, specificity and accuracy of different methods were calculated according to final diagnosis. The sensitivity, specificity and accuracy were, respectively, 77.8%, 43.8% and 53.0% for the cut-off at 5%; 72.2%, 66.7% and 68.2% for the cut-off at 10%; 66.7%, 75.0% and 72.7% for the cut-off at 15%; 66.7%, 85.4% and 80.3% for the cut-off at 20%; 33.3%, 93.8% and 77.3% for the cut-off at 30%. BMS provided a significantly higher diagnostic performance than 5%, 10% and 15% thresholds. Conversely, we did not observe any statistically significant difference between BMS and the cut-off of more than 20%. Therefore, doubtful cases should be analysed semi-quantitatively. An increase in T/B ratio of more than 20% between delayed and late images, should be considered as a criterion of positivity, thus avoiding BMS. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/33322146; info:eu-repo/semantics/altIdentifier/wos/WOS:000602102800001; volume:9; issue:12; firstpage:1; lastpage:13; numberofpages:13; journal:JOURNAL OF CLINICAL MEDICINE; https://hdl.handle.net/11573/1648046 |
| DOI: |
10.3390/jcm9124031 |
| Availability: |
https://hdl.handle.net/11573/1648046; https://doi.org/10.3390/jcm9124031 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.A9EECE23 |
| Database: |
BASE |