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

Abstract

Cranial and spinal infections are severe events that require timely diagnosis and treatment. Physical and neurological examination, laboratory tests and radiological imaging may be insufficient for assessing cranial and spinal septic lesions. This study aimed to evaluate the accuracy of indium-111 white blood cell (WBC) scan in assessing the presence of leucocytes in intracranial and spinal lesions, and in the diagnosis, management and follow-up of primary, post-traumatic and post-surgical infections. One hundred and twenty-four subjects were included in the study (48 with post-traumatic or post-surgical lesions, 73 with primary cerebral lesions, and 3 with spinal lesions). All patients underwent a diagnostic work-up including planar scans with 111In-labelled WBCs, at 4 and 24 h post tracer injection. All subjects underwent surgical treatment. Patients who did not recover from the infection as suggested by clinical evolution underwent further treatment (up to three times) and further WBC scans (up to four times). WBC scintigraphy correctly identified all the areas of leucocyte accumulation, as confirmed after surgery. WBC scintigraphy also correctly excluded the presence of leucocytes 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 accumulation can ease the diagnosis of infection, and indicate that the method is also accurate for the follow-up and management of neurosurgical patients.

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

“…9 These authors further pointed out that 1 month of treatment led to normalization of the indium scan, a result that is not inconsistent with the work of Datz and Thorne. 10 The radionuclide (indium)-labeled leukocyte scan Two studies 11,12 have claimed that indium scan is 100% sensitive; one of these also found the study to be 100% specific. 12 Our results bring such reports into question.…”

“…10 The radionuclide (indium)-labeled leukocyte scan Two studies 11,12 have claimed that indium scan is 100% sensitive; one of these also found the study to be 100% specific. 12 Our results bring such reports into question.…”