H. Amaral et al., Cold-hot mismatch between Tc-99m HMPAO-labeled leukocytes and Tc-99m ciprofloxacin in axial skeleton infections - A report of three cases, CLIN NUCL M, 24(11), 1999, pp. 855-858
Radiolabeled leukocyte scintigraphy is a well-established technique for the
diagnosis of inflammation and infection with a typical presentation of a h
ot spot within the abnormal areas. However, in some cases of osteomyelitis
of the axial skeleton, a cold defect pattern has been described, Tc-99m cip
rofloxacin is a new agent claimed to be specific for imaging sites containi
ng viable bacteria. In this report, we present three cases of proved bacter
ial infection of the axial skeleton with a mismatch pattern between Tc-99m
ciprofloxin and tagged leukocytes, Although Tc-99m-labeled leukocyte scanni
ng showed a cold defect, probably caused by bone marrow replacement, the Tc
-99m ciprofloxacin consecutively revealed a hot spot at the site of infecti
on, These data suggest that Tc-99m ciprofloxacin should be a better agent t
han radiolabeled leukocytes for detecting osteomyelitis of the axial skelet
on.