Gallium Scan Whole Body Ga-67 scintigraphy combined with SPECT can be used to evaluate suspected infection involving a decubitus ulcer or wound overlying the spine. Ga-67 is less sensitive (73%) but more specific (61%) than skeletal scintigraphy [31]. The disadvantages of the gallium examination include a requirement for delayed images (24 to 72 hours) [31]. A dual Ga-67 and Tc-99m-MDP examination has a similar sensitivity (73%) and an increased specificity (81%) [31]. This combined examination may be utilized in select clinical situations such as when spine infection is suspected adjacent to a decubitus ulcer or wound [31]. WBC Scan and Sulfur Colloid Scan Complete Spine A labeled leukocyte and sulfur colloid study is limited in the evaluation of spine infection because areas of infection often demonstrate decreased or absent radionuclide uptake [31]. Suspected Spine Infection FDG-PET/CT Whole Body FDG-PET with CT has seen increasing application for the assessment of suspected spine infection in select cases as a complementary examination [10,31]. Increased FDG uptake is seen at sites of infection with an elevated SUVmax value. FDG-PET/CT can be used in the evaluation of the postsurgical spine for suspected infection of the skin wound when MRI is inconclusive. Variant 5: Suspected spine infection (such as epidural abscess or discitis osteomyelitis). Abnormal radiographs or CT findings. Next imaging study. When an imaging study such as a radiograph or CT of the spine raises a concern for possible spine infection, additional imaging may be required. Because there are other pathologic entities, such as degenerative, traumatic, or inflammatory spondyloarthropathy, which can simulate spine infection on the initial radiographs or CT images, additional imaging is used in conjunction with the clinical evaluation in order to make the appropriate diagnosis [55]. The body regions covered in this clinical scenario are the cervical, thoracic, and lumbar spine.
Suspected Spine Infection PCAs. Gallium Scan Whole Body Ga-67 scintigraphy combined with SPECT can be used to evaluate suspected infection involving a decubitus ulcer or wound overlying the spine. Ga-67 is less sensitive (73%) but more specific (61%) than skeletal scintigraphy [31]. The disadvantages of the gallium examination include a requirement for delayed images (24 to 72 hours) [31]. A dual Ga-67 and Tc-99m-MDP examination has a similar sensitivity (73%) and an increased specificity (81%) [31]. This combined examination may be utilized in select clinical situations such as when spine infection is suspected adjacent to a decubitus ulcer or wound [31]. WBC Scan and Sulfur Colloid Scan Complete Spine A labeled leukocyte and sulfur colloid study is limited in the evaluation of spine infection because areas of infection often demonstrate decreased or absent radionuclide uptake [31]. Suspected Spine Infection FDG-PET/CT Whole Body FDG-PET with CT has seen increasing application for the assessment of suspected spine infection in select cases as a complementary examination [10,31]. Increased FDG uptake is seen at sites of infection with an elevated SUVmax value. FDG-PET/CT can be used in the evaluation of the postsurgical spine for suspected infection of the skin wound when MRI is inconclusive. Variant 5: Suspected spine infection (such as epidural abscess or discitis osteomyelitis). Abnormal radiographs or CT findings. Next imaging study. When an imaging study such as a radiograph or CT of the spine raises a concern for possible spine infection, additional imaging may be required. Because there are other pathologic entities, such as degenerative, traumatic, or inflammatory spondyloarthropathy, which can simulate spine infection on the initial radiographs or CT images, additional imaging is used in conjunction with the clinical evaluation in order to make the appropriate diagnosis [55]. The body regions covered in this clinical scenario are the cervical, thoracic, and lumbar spine.