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The value of Tc-99m (V) dimercaptosuccinic acid in detecting intra-abdominal infection: compared with gallium scan

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Abstract

Objective

Gallium-67 (Ga-67) and labeled leukocytes are useful in the detection of an unknown infectious source. However, the delay in the diagnosis of a Ga-67 citrate scan (gallium scan) and the complicated labeling technique of a leukocyte scan are major drawbacks to their clinical use. Recently, Tc-99m (V) dimercaptosuccinic acid (DMSA) has been found to be very useful in the detection of infection. Tc-99m (V) DMSA is inexpensive, easy to prepare, and provides a result within hours. In this study, we evaluated the potential of Tc-99m (V) DMSA scan (DMSA scan) in the detection of intra-abdominal infection.

Methods

A total of 33 patients who suffered from an unknown cause of fever after colorectal surgery were enrolled in this study. All patients received both a gallium scan and a DMSA scan. DMSA scintigraphy was performed 3–4 h after an injection of 740 MBq (20 mCi) of Tc-99m DMSA. After completion of the DMSA image, 111 MBq (3 mCi) of Ga-67 citrate was injected intravenously. Gallium scintigraphy was performed after 24 h and later as needed.

Results

Of the 33 patients, 17 (51.5%) were diagnosed with intra-abdominal abscesses. For DMSA scans, the sensitivity, specificity, and overall accuracy were 88.2%, 93.7%, and 90.9%, respectively. For gallium scans, the diagnostic sensitivity, specificity, and accuracy were 100%, 87.5%, and 93.9%, respectively. No statistical difference was found in the diagnostic accuracy between these two diagnostic modalities using Fisher's exact test.

Conclusions

DMSA scan is a useful alternative to gallium scan in the detection of intra-abdominal infection in patients with colorectal surgery because Tc-99m DMSA is inexpensive, easy to prepare, and most importantly the result can be obtained within hours.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Taichung Harbor Road, Section 3, Taichung, 407, Taiwan

    Wan-Yu Lin

  2. Institute of Biomedical Engineering, National Chung-Hsing University, Taichung, Taiwan

    Wan-Yu Lin

  3. Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan

    Guang-Uei Hung

  4. Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan

    Te-Hsin Chao

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  1. Wan-Yu Lin
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  2. Guang-Uei Hung
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Correspondence to Wan-Yu Lin.

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Lin, WY., Hung, GU. & Chao, TH. The value of Tc-99m (V) dimercaptosuccinic acid in detecting intra-abdominal infection: compared with gallium scan. Ann Nucl Med 21, 285–291 (2007). https://doi.org/10.1007/s12149-007-0021-3

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