Use of 99m Tc-Sulesomab for the Diagnosis of Prosthesis Infection after Total Joint Arthroplasty

This study aimed to evaluate the diagnostic efficacy of antigranulocyte scintigraphy using the antibody fragment ^99mTc-sulesomab (LeukoScan®) for the diagnosis of prosthesis infection in patients with total hip or knee arthroplasty. The results from 19 patients with suspected total joint arthroplasty infection who had undergone a three-phase bone scan and a subsequent examination with ^99mTc-sulesomab during a 1-year period were reviewed. Twelve patients were shown to have prosthesis infection on culture of aspirated synovial fluid or intra-operative samples. The overall sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for ^99mTc-sulesomab were 75%, 86%, 90%, 66% and 79%, respectively, compared with 54%, 83%, 88%, 45% and 63%, respectively, for the three-phase bone scan. This study showed that ^99mTc-sulesomab had good diagnostic value for the detection of prosthesis infection. The combination of ^99mTc-sulesomab with other laboratory or imaging examinations may improve diagnostic performance in prosthesis infection and should be investigated further.