Indium-111 labelled white blood cell scintigraphy in cranial and spinal septic lesions

Cranial and spinal infections are severe events that require timely diagnos is and treatment, Physical and neurological examination, laboratory tests a nd radiological imaging may be insufficient for assessing cranial and spina l septic lesions. This study aimed to evaluate the accuracy of indium-lll w hite blood cell (WBC) scan in assessing the presence of leucocytes in intra cranial and spinal lesions, and in the diagnosis, management and follow-up of primary, post-traumatic and post-surgical infections, One hundred and tw enty-four subjects were included in the study (48 with post-traumatic or po st-surgical lesions, 73 with primary cerebral lesions, and 3 with spinal le sions), All patients underwent a diagnostic work-up including planar scans with In-111-labelled WBCs, at 4 and 24 h post tracer injection. All subject s underwent surgical treatment. Patients who did not recover from the infec tion as suggested by clinical evolution underwent further treatment (up to three times) and further WBC scans (up to four times). WBC scintigraphy cor rectly identified all the areas of leucocyte accumulation, as confirmed aft er surgery. WBC scintigraphy also correctly excluded the presence of leucoc ytes in all other lesions, as demonstrated at surgery. The results of this study confirm the accuracy of WBC scan for the assessment of patients with cranial and spinal lesions, in whom the demonstration of leucocyte accumula tion can ease the diagnosis of infection, and indicate that the method is a lso accurate for the follow-up and management of neurosurgical patients.