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European Journal of Nuclear Medicine and Molecular Imaging

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01.11.2004 | Original Article

Clinical feasibility of two-step streptavidin/¹¹¹In-biotin scintigraphy in patients with suspected vertebral osteomyelitis

verfasst von: Elena Lazzeri, Ernest K. J. Pauwels, Paola A. Erba, Duccio Volterrani, Mario Manca, Lisa Bodei, Donatella Trippi, Antonio Bottoni, Renza Cristofani, Vincenzo Consoli, Christopher J. Palestro, Giuliano Mariani

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2004

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Abstract

Purpose

Streptavidin accumulates at sites of inflammation and infection as a result of increased capillary permeability. In addition to being utilised by bacteria for their own growth, biotin forms a stable, high-affinity non-covalent complex with avidin. The objective of this investigation was to determine the diagnostic performance of two-step streptavidin/¹¹¹In-biotin imaging for evaluating patients with suspected vertebral osteomyelitis.

Methods

We evaluated 55 consecutive patients with suspected vertebral osteomyelitis (34 women and 21 men aged 27–86 years), within 2 weeks after the onset of clinical symptoms. Thirty-two of the patients underwent magnetic resonance imaging (MRI) and 24, computed tomography (CT). DTPA-conjugated biotin was radiolabelled by incubating 500 μg of DTPA-biotin with 111 MBq of¹¹¹In-chloride. Two-step scintigraphy was performed by first infusing 3 mg streptavidin intravenously, followed 4 h later by¹¹¹In-biotin. Imaging was begun 60 min later.

Results

Streptavidin/¹¹¹In-biotin scintigraphy was positive in 32/34 patients with spinal infection (94.12% sensitivity). The study was negative in 19/21 patients without infection (95.24% specificity). The corresponding results for MRI and CT were 54.17% and 35.29% (sensitivity), and 75% and 57.14% (specificity), respectively. All statistical parameters of diagnostic performance (Youden’s J index, kappa measure of agreement with correct classification, accuracy, sensitivity, specificity, positive likelihood and negative likelihood) were clearly better for streptavidin/¹¹¹In-biotin scintigraphy than for either MRI or CT.

Conclusion

Streptavidin/¹¹¹In-biotin scintigraphy is highly sensitive and specific for detecting vertebral osteomyelitis in the first 2 weeks after the onset of clinical symptoms, and is potentially very useful for guiding clinical decisions on instituting appropriate therapy.

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Titel: Clinical feasibility of two-step streptavidin/111In-biotin scintigraphy in patients with suspected vertebral osteomyelitis
verfasst von: Elena Lazzeri
Ernest K. J. Pauwels
Paola A. Erba
Duccio Volterrani
Mario Manca
Lisa Bodei
Donatella Trippi
Antonio Bottoni
Renza Cristofani
Vincenzo Consoli
Christopher J. Palestro
Giuliano Mariani
Publikationsdatum: 01.11.2004
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2004
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-004-1581-2

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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