The role of Ga-67 in the early detection of spinal epidural abscesses

In this study, we evaluated the role of Ga-67 whole-body and single photon emission tomographic (SPET) imaging in the early diagnosis and lesion local ization of spinal epidural abscess before confirmation by gadolinium-enhanc ed magnetic resonance imaging (MRI). Six patients with fever of unknown ori gin had a Ga-67 whole-body scan, four of whom also underwent SPET imaging. For further confirmation of a spinal epidural abscess, gadolinium-enhanced MRT was performed in all patients. All patients had increased Ga-67 uptake in a spinal or paraspinal area on the whole-body scan. They were later conf irmed to have a spinal epidural abscess after gadolinium-enhanced MRI. Of t hese six patients, five underwent surgical drainage plus parenterally admin istered antibiotics, and had complete or partial recovery. One died before operation due to sepsis. In conclusion, we suggest performing a Ga-67 whole -body survey as early as possible in patients with fever of unknown origin, fever and back pain and/or the spinal syndrome, before MRI is performed. I f a spinal epidural abscess is strongly suspected, SPET is needed for furth er confirmation of spinal versus non-spinal and contiguous versus non-conti guous lesion(s). If MRI is unavailable, then Ga-67 scintigraphy is a satisf actory method for investigating spinal epidural abscesses. ((C) 2000 Lippin cott Williams & Wilkins).