Clinical impact of SPECT/CT with In-111 biotin on the management of patients with suspected spine infection.

PURPOSE

Early identification and localization of spine infection is necessary for adequate therapeutic strategy. To localize the precise site of infection we evaluated In-111 Biotin SPECT/CT versus planar and SPECT imaging.

METHODS

Seventy-two consecutive patients were enrolled and underwent SPECT/CT and planar imaging 2 to 4 hours post i.v. injection of In-111 Biotin. Final diagnosis was based on bacterial cultures and/or clinical/imaging follow-up for at least 1 year. We evaluated the diagnostic performance of planar, SPECT, and SPECT/CT In-111 Biotin scintigraphy.

RESULTS

In-111 Biotin SPECT/CT and SPECT showed similar values of sensitivity (93.5% vs. 92.1%) and the same specificity (92.3%), planar imaging showed 80.4% of sensitivity and 69.2% of specificity. In 16 patients SPECT/CT correctly localized the infection site (bone, soft tissue, or both bone and soft tissue).

CONCLUSIONS

SPECT/CT enhances the impact of In-111 Biotin scintigraphy on the clinical management of patients, allowing the exact site of infection to be localized to select the appropriate therapy.