EVALUATION OF COMPLICATING OSTEOMYELITIS WITH TC-99M MDP, IN-111 GRANULOCYTES, AND CITRATE-GA-67

Abstract

Studies with 67Ga and 3-phase bone imaging (TPBS), though very sensitive, are not very specific in evaluating suspected osteomyelitis (OM) that is superimposed upon other diseases causing increased bone turnover. A total of 57 patients with suspected OM were studied; this included 48 with increased bone turnover. All of the patients were studied with granulocytes labeled with 111In acetylacetone (111In GRAN), TPBS and 29 of these ptatients had 67Ga studies as well. 111In GRAN had a sensitivity of 100% in acute OM and 60% in chronic OM, with a specificity of 96%. 67Ga was excellent in ruling out OM when the study was normal, or in ruling in OM when the relative uptake of 67Ga exceeded the uptake of 99mTc MDP [methylene diphosphonate] or when the 67Ga in bone had a different distribution from the TPBS. These criteria were met in only 28% of the subjects. When added to TPBS, the 111In GRAN study plays an important role in detecting complicating OM.