Immunoscintigraphy with antigranulocyte monoclonal antibodies for the diagnosis of septic loosening of hip prostheses.

Détails

ID Serval
serval:BIB_578A17856445
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Immunoscintigraphy with antigranulocyte monoclonal antibodies for the diagnosis of septic loosening of hip prostheses.
Périodique
European journal of nuclear medicine
Auteur(s)
Boubaker A., Bischof Delaloye A., Blanc C.H., Dutoit M., Leyvraz P.F., Delaloye B.
ISSN
0340-6997
Statut éditorial
Publié
Date de publication
1995
Peer-reviewed
Oui
Volume
22
Numéro
2
Pages
139-47
Langue
anglais
Notes
Publication types: Journal Article - Publication Status: ppublish
Résumé
To determine the value of immunoscintigraphy (IS) with antigranulocyte monoclonal antibodies (Mab) in the diagnosis of subacute or chronic infection of hip prostheses, we prospectively studied 57 patients (23 women and 34 men; age 29-92 years, mean 72.7 years) sent to our institution in the past 6 years for clinical suspicion of septic loosening of a hip prosthesis. Nineteen patients had bilateral prostheses and one of them was studied twice. A total of 78 prostheses were examined. All patients had three-phase bone scans followed by IS with technetium-99m antigranulocyte Mab BW 250/183. Intervals between bone scans and IS varied from 2 days to 4 weeks. Final diagnosis was assessed by culture in 48 cases (articular puncture or intraoperative sampling) and by clinical follow-up of at least 8 months in 30 cases. Twelve prostheses were considered septic and 66 non-septic. The overall sensitivity and specificity were 92% and 64% respectively for bone scans, 67% and 75% for IS and 67% and 84% for both modalities together. In three cases, IS was doubtful and the final clinical diagnosis was negative for infection. False-positive results were observed in the presence of massive loosening of the prosthesis or in association with metaplastic peri-articular bone formation. In three of the four false-negative results, infection was proven only after enrichment of the culture, and the bacterium was Staphylococcus epidermidis. In 12/33 (36%) positive bone scans IS allowed the diagnosis of infection to be excluded. Overall accuracy of both modalities together was 81% and the negative predictive value was 93%, which compares favourably with the results reported for other non-invasive methods.
Mots-clé
Aged, Bone and Bones, Diphosphonates, Evaluation Studies as Topic, Female, Hip Prosthesis, Humans, Male, Organotechnetium Compounds, Predictive Value of Tests, Prospective Studies, Prosthesis Failure, Prosthesis-Related Infections, Radioimmunodetection, Sensitivity and Specificity, Staphylococcal Infections, Staphylococcus epidermidis
Pubmed
Web of science
Création de la notice
24/01/2008 15:13
Dernière modification de la notice
20/08/2019 14:11
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