Skip to main content

Radionuclide Imaging of Skeletal Implants

  • Chapter
  • First Online:
Radiology of Orthopedic Implants

Abstract

Radionuclides are atomic species that are inherently unstable and decay emitting energy in the form of ionising radiation. Nuclear medicine or radionuclide imaging studies use a variety of radionuclides, usually bound to a further molecule to form a radiopharmaceutical. The radionuclide acts as the marker that allows localisation and formation of an image with a camera/scanner system, whilst the radiopharmaceutical (with the carrier molecule) gives the tracer specificity.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rushton N, Coakley AJ, Tudor J, Wraight EP. The value of technetium and gallium scanning in assessing pain after total hip replacement. J Bone Joint Surg Br. 1982;64(3):313–8.

    Article  CAS  PubMed  Google Scholar 

  2. Smith SL, Wastie ML, Forster I. Radionuclide bone scintigraphy in the detection of significant complications after total knee joint replacement. Clin Radiol. 2001;56(3):221–4.

    Article  CAS  PubMed  Google Scholar 

  3. Levitsky KA, Hozack WJ, Balderston RA, Rothman RH, Gluckman SJ, Maslack MM, et al. Evaluation of the painful prosthetic joint. Relative value of bone scan, sedimentation rate, and joint aspiration. J Arthroplasty. 1991;6(3):237–44.

    Article  CAS  PubMed  Google Scholar 

  4. Gemmel F, Van den Wyngaert H, Love C, Welling MM, Gemmel P, Palestro CJ. Prosthetic joint infections: radionuclide state-of-the-art imaging. Eur J Nucl Med Mol Imaging. 2012;39(5):892–909.

    Article  CAS  PubMed  Google Scholar 

  5. Merkel KD, Brown ML, Fitzgerald RH. Sequential technetium-99m HMDP-gallium-67 citrate imaging for the evaluation of infection in the painful prosthesis. J Nucl Med. 1986;27(9):1413–7.

    PubMed  CAS  Google Scholar 

  6. Schauwecker DS, Park HM, Mock BH, Burt RW, Kernick CB, Ruoff AC, et al. Evaluation of complicating osteomyelitis with Tc-99m MDP, In-111 granulocytes, and Ga-67 citrate. J Nucl Med. 1984;25(8):849–53.

    PubMed  CAS  Google Scholar 

  7. Palestro CJ, Swyer AJ, Kim CK, Goldsmith SJ. Infected knee prosthesis: diagnosis with In-111 leukocyte, Tc-99m sulfur colloid, and Tc-99m MDP imaging. Radiology. 1991;179(3):645–8.

    Article  CAS  PubMed  Google Scholar 

  8. McAfee JG, Thakur ML. Survey of radioactive agents for in vitro labeling of phagocytic leukocytes. I. Soluble agents. J Nucl Med. 1976;17(6):480–7.

    PubMed  CAS  Google Scholar 

  9. McAfee JG, Thakur ML. Survey of radioactive agents for in vitro labeling of phagocytic leukocytes. II. Particles. J Nucl Med. 1976;17(6):488–92.

    PubMed  CAS  Google Scholar 

  10. Peters AM, Danpure HJ, Osman S, Hawker RJ, Henderson BL, Hodgson HJ, et al. Clinical experience with 99mTc-hexamethylpropylene-amineoxime for labelling leucocytes and imaging inflammation. Lancet. 1986;2(8513):946–9.

    Article  CAS  PubMed  Google Scholar 

  11. Palestro CJ, Love C, Bhargava KK. Labeled leukocyte imaging: current status and future directions. Q J Nucl Med Mol Imaging. 2009;53(1):105–23.

    PubMed  CAS  Google Scholar 

  12. Palestro CJ, Torres MA. Radionuclide imaging of nonosseous infection. Q J Nucl Med. 1999;43(1):46–60.

    PubMed  CAS  Google Scholar 

  13. Bosetti M, Cannas M. The effect of bioactive glasses on bone marrow stromal cells differentiation. Biomaterials. 2005;26(18):3873–9.

    Article  CAS  PubMed  Google Scholar 

  14. Palestro CJ, Mehta HH, Patel M, Freeman SJ, Harrington WN, Tomas MB, et al. Marrow versus infection in the Charcot joint: indium-111 leukocyte and technetium-99m sulfur colloid scintigraphy. J Nucl Med. 1998;39(2):346–50.

    PubMed  CAS  Google Scholar 

  15. Palestro CJ, Roumanas P, Swyer AJ, Kim CK, Goldsmith SJ. Diagnosis of musculoskeletal infection using combined In-111 labeled leukocyte and Tc-99m SC marrow imaging. Clin Nucl Med. 1992;17(4):269–73.

    Article  CAS  PubMed  Google Scholar 

  16. de Vries EF, Roca M, Jamar F, Israel O, Signore A. Guidelines for the labelling of leucocytes with (99m)Tc-HMPAO. Inflammation/Infection Taskgroup of the European Association of Nuclear Medicine. Eur J Nucl Med Mol Imaging. 2010;37(4):842–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hammersley PA, Nkohkwo AT. Studies on white blood cell labelling: (99)Tc(m)-HMPAO preferentially labels granulocytes. Nucl Med Commun. 2001;22(9):981–6.

    Article  CAS  PubMed  Google Scholar 

  18. Peters AM. The utility of [99mTc]HMPAO-leukocytes for imaging infection. Semin Nucl Med. 1994;24(2):110–27.

    Article  CAS  PubMed  Google Scholar 

  19. Roca M, de Vries EF, Jamar F, Israel O, Signore A. Guidelines for the labelling of leucocytes with (111)In-oxine. Inflammation/Infection Taskgroup of the European Association of Nuclear Medicine. Eur J Nucl Med Mol Imaging. 2010;37(4):835–41.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Agool A, Glaudemans AW, Boersma HH, Dierckx RA, Vellenga E, Slart RH. Radionuclide imaging of bone marrow disorders. Eur J Nucl Med Mol Imaging. 2011;38(1):166–78.

    Article  PubMed  Google Scholar 

  21. Wilhelm AJ, Mijnhout GS, Franssen EJ. Radiopharmaceuticals in sentinel lymph-node detection—an overview. Eur J Nucl Med. 1999;26(4 Suppl):S36–42.

    Article  CAS  PubMed  Google Scholar 

  22. Erba PA, Glaudemans AW, Veltman NC, Sollini M, Pacilio M, Galli F, et al. Image acquisition and interpretation criteria for 99mTc-HMPAO-labelled white blood cell scintigraphy: results of a multicentre study. Eur J Nucl Med Mol Imaging. 2014;41(4):615–23.

    Article  PubMed  Google Scholar 

  23. Palestro CJ, ML. Brown, Forstrom LA, Bennett S. Greenspan, McAfee JG, Royal HD, et al. Society of nuclear medicine procedure guideline for 99mTc-exametazime (HMPAO)-labeled leukocyte scintigraphy for suspected infection/inflammation, version 3.0. Society of nuclear medicine procedure guidelines; 2004.

    Google Scholar 

  24. Palestro CJ, Brown ML, Forstrom LA, McAfee JG, Royal HD, Schauwecker DS, et al. Society of nuclear medicine procedure guideline for 111In-leukocyte scintigraphy for suspected infection/inflammation, version 3.0. Society of nuclear medicine procedure guidelines; 2004.

    Google Scholar 

  25. Kim HO, Na SJ, Oh SJ, Jung BS, Lee SH, Chang JS, et al. Usefulness of adding SPECT/CT to 99mTc-hexamethylpropylene amine oxime (HMPAO)-labeled leukocyte imaging for diagnosing prosthetic joint infections. J Comput Assist Tomogr. 2014;38(2):313–9.

    Article  PubMed  Google Scholar 

  26. Djekidel M, Brown RK, Piert M. Benefits of hybrid SPECT/CT for (111)In-oxine- and Tc-99m-hexamethylpropylene amine oxime-labeled leukocyte imaging. Clin Nucl Med. 2011;36(7):e50–6.

    Article  PubMed  Google Scholar 

  27. Filippi L, Schillaci O. Usefulness of hybrid SPECT/CT in 99mTc-HMPAO-labeled leukocyte scintigraphy for bone and joint infections. J Nucl Med. 2006;47(12):1908–13.

    PubMed  CAS  Google Scholar 

  28. Hulme KW, Kappadath SC. Implications of CT noise and artifacts for quantitative 99mTc SPECT/CT imaging. Med Phys. 2014;41(4):042502.

    Article  CAS  PubMed  Google Scholar 

  29. Palestro CJ, Love C, Tronco GG, Tomas MB, Rini JN. Combined labeled leukocyte and technetium 99m sulfur colloid bone marrow imaging for diagnosing musculoskeletal infection. Radiographics. 2006;26(3):859–70.

    Article  PubMed  Google Scholar 

  30. Love C, Palestro CJ. Radionuclide imaging of inflammation and infection in the acute care setting. Semin Nucl Med. 2013;43(2):102–13.

    Article  PubMed  Google Scholar 

  31. Love C, Opoku-Agyemang P, Tomas MB, Pugliese PV, Bhargava KK, Palestro CJ. Pulmonary activity on labeled leukocyte images: physiologic, pathologic, and imaging correlation. Radiographics. 2002;22(6):1385–93.

    Article  PubMed  Google Scholar 

  32. el Esper I, Dacquet V, Paillard J, Bascoulergue G, Tahon MM, Fonroget J. 99Tcm-HMPAO-labelled leucocyte scintigraphy in suspected chronic osteomyelitis related to an orthopaedic device: clinical usefulness. Nucl Med Commun. 1992;13(11):799–805.

    Article  PubMed  Google Scholar 

  33. Devillers A, Moisan A, Jean S, Arvieux C, Bourguet P. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy for the diagnosis of bone and joint infections: a retrospective study in 116 patients. Eur J Nucl Med. 1995;22(4):302–7.

    Article  CAS  PubMed  Google Scholar 

  34. Pelosi E, Baiocco C, Pennone M, Migliaretti G, Varetto T, Maiello A, et al. 99mTc-HMPAO-leukocyte scintigraphy in patients with symptomatic total hip or knee arthroplasty: improved diagnostic accuracy by means of semiquantitative evaluation. J Nucl Med. 2004;45(3):438–44.

    PubMed  Google Scholar 

  35. Scher DM, Pak K, Lonner JH, Finkel JE, Zuckerman JD, Di Cesare PE. The predictive value of indium-111 leukocyte scans in the diagnosis of infected total hip, knee, or resection arthroplasties. J Arthroplast. 2000;15(3):295–300.

    Article  CAS  Google Scholar 

  36. Wukich DK, Abreu SH, Callaghan JJ, Van Nostrand D, Savory CG, Eggli DF, et al. Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells. J Bone Joint Surg Am. 1987;69(9):1353–60.

    Article  CAS  PubMed  Google Scholar 

  37. Rand JA, Brown ML. The value of indium 111 leukocyte scanning in the evaluation of painful or infected total knee arthroplasties. Clin Orthop Relat Res. 1990;259:179–82.

    Google Scholar 

  38. Magnuson JE, Brown ML, Hauser MF, Berquist TH, Fitzgerald RH, Klee GG. In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities. Radiology. 1988;168(1):235–9.

    Article  CAS  PubMed  Google Scholar 

  39. Bar-Shalom R, Yefremov N, Guralnik L, Keidar Z, Engel A, Nitecki S, et al. SPECT/CT using 67Ga and 111In-labeled leukocyte scintigraphy for diagnosis of infection. J Nucl Med. 2006;47(4):587–94.

    PubMed  Google Scholar 

  40. Seabold JE, Nepola JV, Marsh JL, Hawes DR, Justin EP, Ponto JA, et al. Postoperative bone marrow alterations: potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte scintigraphy. Radiology. 1991;180(3):741–7.

    Article  CAS  PubMed  Google Scholar 

  41. Becker W, Palestro CJ, Winship J, Feld T, Pinsky CM, Wolf F, et al. Rapid imaging of infections with a monoclonal antibody fragment (LeukoScan). Clin Orthop Relat Res. 1996;(329):263–72.

    Google Scholar 

  42. Sousa R, Massada M, Pereira A, Fontes F, Amorim I, Oliveira A. Diagnostic accuracy of combined 99mTc-sulesomab and 99mTc-nanocolloid bone marrow imaging in detecting prosthetic joint infection. Nucl Med Commun. 2011;32(9):834–9.

    Article  PubMed  Google Scholar 

  43. Rubello D, Rampin L, Banti E, Massaro A, Cittadin S, Cattelan AM, et al. Diagnosis of infected total knee arthroplasty with anti-granulocyte scintigraphy: the importance of a dual-time acquisition protocol. Nucl Med Commun. 2008;29(4):331–5.

    Article  PubMed  Google Scholar 

  44. Manthey N, Reinhard P, Moog F, Knesewitsch P, Hahn K, Tatsch K. The use of [18 F]fluorodeoxyglucose positron emission tomography to differentiate between synovitis, loosening and infection of hip and knee prostheses. Nucl Med Commun. 2002;23(7):645–53.

    Article  CAS  PubMed  Google Scholar 

  45. Basu S, Kwee TC, Saboury B, Garino JP, Nelson CL, Zhuang H, et al. FDG PET for diagnosing infection in hip and knee prostheses: prospective study in 221 prostheses and subgroup comparison with combined (111)In-labeled leukocyte/(99m)Tc-sulfur colloid bone marrow imaging in 88 prostheses. Clin Nucl Med. 2014;39(7):609–15.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Patrick Fielding .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Jayaprakasam, V.S., Fielding, P. (2018). Radionuclide Imaging of Skeletal Implants. In: Agarwal, S., Bansal, G. (eds) Radiology of Orthopedic Implants. Springer, Cham. https://doi.org/10.1007/978-3-319-76009-4_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-76009-4_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-76007-0

  • Online ISBN: 978-3-319-76009-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics