Diagnostic sensitivity and specificity of the radionuclide (indium)-labeled leukocyte scan

Clinical Utility of Indium 111–Labeled White Blood Cell Scintigraphy for Evaluation of Suspected Infection

“…Positive scans were more likely to be helpful than negative scans. The sensitivity of 111 In-labeled WBC scans for the diagnosis of infectious conditions was <50%, which is lower than values reported by others [ 2 , 3 , 7 , 8 , 10 ]. Therefore, the decreased utility among negative scans at our center may reflect an appropriate perception by prescribing physicians of the uncertainty of negative test results.…”

“…111 In-labeled WBC scans detect localized inflammation, but do not clearly distinguish between infectious and noninfectious inflammatory processes [ 1 ]. 111 In-labeled WBC scans have been used in the diagnostic evaluation of fever of unknown origin (FUO) [ 2 – 4 ], prosthetic joint infections [ 3 ], vascular graft infections [ 5 – 7 ], and osteomyelitis [ 3 , 8 ].…”

“…Providers look to the results of 111 In scans to inform clinical decision making. However, Wanahita et al postulated that, despite sensitivity and specificity >80%, 111 In-labeled WBC scans are not accurate enough to meaningfully impact clinical care in cases of difficult clinical decisions, such as whether or not to perform a revision arthroplasty on a suspected prosthetic joint infection [ 3 ]. This assertion warrants further evaluation.…”

SPECT/CT in infection and inflammation

“…Early imaging, at between 30 min and 1 h after tracer injection, can be used optionally as a surrogate for bone marrow uptake [20]. WBC scintigraphy has a diagnostic accuracy of up to 89 % and sensitivity and specificity values ranging from 83 to 89 % and from 84 to 90 %, respectively [21][22][23][24]. In the event of doubtful images with suspected bone marrow expansion, imaging with 99m Tc-colloids can be added to reduce the false-positive rate [25].…”

Predictors of Diagnostic Efficacy of Tagged White Blood Cell Scans in the Evaluation of Occult Infection

“…1 The TWBCSs are commonly obtained during the evaluation of suspected occult infection, the most well-defined occult infection being the fever of unknown origin (FUO). 4 Other investigations have been more specific for FUO, finding that TWBCSs are not particularly useful in spontaneous FUO 5 beyond confirming the location of a known focus of infection 6 but may be helpful in cases of postoperative FUO. One study examined the correlation of TWBCS with radiographic imaging findings, with the results suggesting that scintigraphy results do correlate with imaging.…”