Decisive diagnosis of infected mandibular osteoradionecrosis with a Tc-99m-labelled anti-granulocyte Fab'-fragment
Kampen, W.U.; Brenner, W.; Terheyden, H.; Bohuslavizki, K.H.; Henze, E.
Nuklearmedizin. Nuclear Medicine 38(7): 309-311
1999
ISSN/ISBN: 0029-5566 PMID: 10599073 Document Number: 499427
The accepted golden standard for detection of inflammatory bone disease is conventional three-phase bone scanning. Hyperperfusion, a high blood-pool activity and elevated bone metabolism are typical signs for an acute osteomyelitis. However, in case of subacute, chronic inflammation, neither elevated blood flow nor high blood-pool activity may be seen. This may cause difficulties in differentiating such cases from neoplastic or postoperative changes. This case report verifies the possible advantage of immunoscintigraphy with Tc-99m-labelled anti-granulocyte Fab'-fragments (LeukoScan) in a patient with infected mandibular osteoradionecrosis, who had equivocal clinical symptoms and questionable radiographic results. LeukoScan is shown to be more sensitive in case of subacute bone inflammation compared with three-phase bone scanning. However, acquisition of delayed images after 24 hours including SPECT is inevitable in case of negative scans during the first hours of investigation.