Diagnostic Significance of Indium-111 Granulocyte Scintigraphy in Febrile Patients

• Published in: The Journal of nuclear medicine (1978) Vol. 28; no. 2; p. 155
• Main Authors: Syrjala, Martti T, Valtonen, Ville, Liewendahl, Kristian, Myllyla, Gunnar
• Format: Journal Article
• Language: English
• Published: United States Soc Nuclear Med 01.02.1987
• Subjects: Adult; Aged; Aged, 80 and over; Bacterial Infections - diagnostic imaging; Blood Sedimentation; C-Reactive Protein - analysis; Female; Fever - diagnostic imaging; Fever - etiology; Fever of Unknown Origin - diagnostic imaging; Granulocytes; Humans; Indium; Leukocyte Count; Male; Middle Aged; Postoperative Complications - diagnostic imaging; Predictive Value of Tests; Radioisotopes; Radionuclide Imaging; Sepsis - diagnostic imaging
• ISSN: 0161-5505; 1535-5667

Sixty-eight patients with fever of unknown origin, 32 patients with postoperative fever, and 26 patients with therapy-resistant fever after bacteremia were investigated with [111In] granulocyte scintigraphy for the detection of abscesses. The results showed that the value of [111In]granulocyte scintigraphy in the detection of infectious foci vary in these three types of febrile conditions. The overall sensitivity and specificity were 86.5% and 87.8%, respectively. We observed, however, a relatively low predictive value of a positive result in the fever of unknown origin group (73.1%), and also a low predictive value of a negative result in the bacteremia group (66.7%). The C-reactive protein (CRP) levels in patients with a true-positive scintigram were significantly (p less than 0.001) higher than in patients with a true-negative scintigram. There was also a significant positive correlation (p less than 0.01) between the serum CRP concentration and the intensity of the granulocyte accumulations. There was no correlation between the peripheral leukocyte count or the erythrocyte sedimentation rate (ESR) and the intensity of the granulocyte uptake. Therefore CRP, but not the leukocyte count or ESR, appears useful for selecting the patients who benefit most from granulocyte scintigraphy.