Follow-up of 105 patients who did not undergo initial imaging revealed that 10/105 (9.5%) of the patients were readmitted the following year with urosepsis; of these patients, imaging by US or CT was indicated for 6/10, and a major abnormality was detected in 3/6 imaged patients. Hoddick et al [13] in a prospective study of 12 patients with urosepsis who were evaluated with both US and CT. Of these, 6/12 of the patients had renal abscesses, of whom 6/6 (100%) of the patients were identified on both US and contrast-enhanced CT. One patient had multiple perirenal abscesses, and another patient had a gas-forming perinephric abscess that were both missed by US but seen on CT. Sepsis WBC Scan Abdomen and Pelvis When initial cross-sectional imaging is inconclusive in determining the origin of sepsis, radiolabeled WBC scans may be useful as a subsequent imaging study in providing diagnostic information. There is a relative paucity of recent literature regarding the usefulness of WBC scans in the setting of sepsis, and the majority of studies were performed before the routine use of SPECT/CT, which improves the accuracy of radiolabeled WBC scans by co- registering scintigraphic and CT data [19]. Carter et al [20] performed a retrospective review on the usefulness of Indium-111-tagged WBC scan and US in 45 patients with suspected intraabdominal sepsis but without localizing abdominal signs, of whom 22 were ultimately determined to have intraabdominal abscesses. Indium-111-tagged WBC scan correctly identified the intraabdominal abscess in 21/22 patients (sensitivity 95%) and incorrectly predicted abscesses in 2 patients (specificity 91%). All patients had a concurrent US performed and Indium-111-tagged WBC scan was shown to be more sensitive but less specific (US sensitivity was 45% and specificity was 100%).
Sepsis. Follow-up of 105 patients who did not undergo initial imaging revealed that 10/105 (9.5%) of the patients were readmitted the following year with urosepsis; of these patients, imaging by US or CT was indicated for 6/10, and a major abnormality was detected in 3/6 imaged patients. Hoddick et al [13] in a prospective study of 12 patients with urosepsis who were evaluated with both US and CT. Of these, 6/12 of the patients had renal abscesses, of whom 6/6 (100%) of the patients were identified on both US and contrast-enhanced CT. One patient had multiple perirenal abscesses, and another patient had a gas-forming perinephric abscess that were both missed by US but seen on CT. Sepsis WBC Scan Abdomen and Pelvis When initial cross-sectional imaging is inconclusive in determining the origin of sepsis, radiolabeled WBC scans may be useful as a subsequent imaging study in providing diagnostic information. There is a relative paucity of recent literature regarding the usefulness of WBC scans in the setting of sepsis, and the majority of studies were performed before the routine use of SPECT/CT, which improves the accuracy of radiolabeled WBC scans by co- registering scintigraphic and CT data [19]. Carter et al [20] performed a retrospective review on the usefulness of Indium-111-tagged WBC scan and US in 45 patients with suspected intraabdominal sepsis but without localizing abdominal signs, of whom 22 were ultimately determined to have intraabdominal abscesses. Indium-111-tagged WBC scan correctly identified the intraabdominal abscess in 21/22 patients (sensitivity 95%) and incorrectly predicted abscesses in 2 patients (specificity 91%). All patients had a concurrent US performed and Indium-111-tagged WBC scan was shown to be more sensitive but less specific (US sensitivity was 45% and specificity was 100%).