Decisive diagnosis of infected mandibular osteoradionecrosis with a Tc-99m-labelled anti-granulocyte Fab'-fragment

Nuklearmedizin. 1999;38(7):309-11.

Abstract

The accepted golden standard for detection of inflammatory bone disease is conventional three-phase bone scanning. Hyperperfusion, a high blood-pool activity and elevated bone metabolism are typical signs for an acute osteomyelitis. However, in case of subacute, chronic inflammation, neither elevated blood flow nor high blood-pool activity may be seen. This may cause difficulties in differentiating such cases from neoplastic or postoperative changes. This case report verifies the possible advantage of immunoscintigraphy with Tc-99m-labelled anti-granulocyte Fab'-fragments (LeukoScan) in a patient with infected mandibular osteoradionecrosis, who had equivocal clinical symptoms and questionable radiographic results. LeukoScan is shown to be more sensitive in case of subacute bone inflammation compared with three-phase bone scanning. However, acquisition of delayed images after 24 hours including SPECT is inevitable in case of negative scans during the first hours of investigation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Carcinoma, Squamous Cell / radiotherapy
  • Diagnosis, Differential
  • Female
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Magnetic Resonance Imaging
  • Mandibular Diseases / diagnostic imaging*
  • Mandibular Diseases / etiology
  • Mandibular Diseases / surgery
  • Osteoradionecrosis / diagnostic imaging*
  • Osteoradionecrosis / surgery
  • Radiography
  • Radiopharmaceuticals*
  • Radiotherapy / adverse effects
  • Tomography, Emission-Computed, Single-Photon

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Radiopharmaceuticals
  • Sulesomab