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Original Article
Pak J Nucl Med. 2020; 10(1): 13-19

Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections

Authors: Ayesha Ammar, Shazia Fatima, Kahkashan Bahsir Mir, Sadaf Butt, Sadaf Batool, Muhammad Adnan Saeed, Noreen Marwat, Naseer Ahmed.

View PDF HTML FullText DOI: 10.24911/PJNMed.175-1568470299

Abstract

Background: The purpose of this study is to ascertain the utility of Technetium (Tc)-99m-labeled levofloxacin in diagnosing musculoskeletal infections and also to observe its biodistribution in the human body. Patients who were referred with the clinical suspicion of having osteomyelitis underwent Tc-99m levofloxacin imaging. Methods: Tc-99m-labeled levofloxacin scintigraphy was carried out in 30 patients with musculoskeletal infections and the results were compared with the culture and sensitivity of suspected lesions. Results: Fifteen patients were true-positive, 2 were false-positive, 1 was false-negative, and 12 were true-negative. The sensitivity and specificity were 93.8% and 85.7%, respectively. The positive and negative predictive values were 88.2% and 92.3%, respectively. The biodistribution studies revealed that 7.74% ± 0.42% of the injected dose at 1 hour decreased to 5.45% ± 0.37% at 2 hours, and to 2.49% ± 0.55% at 4 hours. The liver showed a mean uptake value of 5.58% of injected activity at 1 hour, which decreased to 3.52% ± 0.30% and 2.00% ± 0.5 0% at 2 and 4 hours, respectively. The activity in the bladder increased from the mean percentage uptake value of 5.45% ± 0.84% at 1 hour to 20.00% ± 3.67% at 2 hours and 39.67% ± 4.23% at 4 hours. The results of Student’s t-test showed significant differences in the uptake values of infected and noninfected sites. Chi-square results confirmed strong association between osteomyelitis and Tc 99m Levofloxacin uptake. Conclusion: Tc-99m-labeled levofloxacin has the potential of simulating an infection-imaging agent.

Keywords:   99mTc levofloxacin, musculoskeletal infections, nuclear medicine


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Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections


Authors
Ayesha Ammar
Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan
PubMed articlesGoogle scholar articles

Shazia Fatima
Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan
PubMed articlesGoogle scholar articles

Kahkashan Bahsir Mir
Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan
PubMed articlesGoogle scholar articles

Sadaf Butt
Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan
PubMed articlesGoogle scholar articles

Sadaf Batool
Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan
PubMed articlesGoogle scholar articles

Muhammad Adnan Saeed
Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan
PubMed articlesGoogle scholar articles

Noreen Marwat
Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan
PubMed articlesGoogle scholar articles

Naseer Ahmed
Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan
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Correspondence to:
. Ayesha Ammar, Nuclear Medicine, Oncology & Radiotherapy Institute (NORI), Islamabad, Pakistan.; ayesha-ammar@hotmail.com

Publication history
Received 14 Sep 2019
Revised 22 Apr 2020
Accepted 20 May 2020
Published online 09 Jul 2020
Published in print 11 Sep 2020
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How to cite this article

Pubmed Style

Ammar A, Fatima S, Mir KB, Butt S, Batool S, Saeed MA, Marwat N, Ahmed N. Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections. Pak J Nucl Med. 2020; 10(1): 13-19. doi:10.24911/PJNMed.175-1568470299


Web Style

Ammar A, Fatima S, Mir KB, Butt S, Batool S, Saeed MA, Marwat N, Ahmed N. Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections. http://www.pjnmed.com/?mno=65498 [Access: August 02, 2021]. doi:10.24911/PJNMed.175-1568470299


AMA (American Medical Association) Style

Ammar A, Fatima S, Mir KB, Butt S, Batool S, Saeed MA, Marwat N, Ahmed N. Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections. Pak J Nucl Med. 2020; 10(1): 13-19. doi:10.24911/PJNMed.175-1568470299


Vancouver/ICMJE Style

Ammar A, Fatima S, Mir KB, Butt S, Batool S, Saeed MA, Marwat N, Ahmed N. Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections. Pak J Nucl Med. (2020), [cited August 02, 2021]; 10(1): 13-19. doi:10.24911/PJNMed.175-1568470299


Harvard Style

Ammar, A., Fatima, . S., Mir, . K. B., Butt, . S., Batool, . S., Saeed, . M. A., Marwat, . N. & Ahmed, . N. (2020) Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections. Pak J Nucl Med, 10 (1), 13-19. doi:10.24911/PJNMed.175-1568470299


Turabian Style

Ammar, Ayesha, Shazia Fatima, Kahkashan Bahsir Mir, Sadaf Butt, Sadaf Batool, Muhammad Adnan Saeed, Noreen Marwat, and Naseer Ahmed. 2020. Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections. Pakistan Journal of Nuclear Medicine, 10 (1), 13-19. doi:10.24911/PJNMed.175-1568470299


Chicago Style

Ammar, Ayesha, Shazia Fatima, Kahkashan Bahsir Mir, Sadaf Butt, Sadaf Batool, Muhammad Adnan Saeed, Noreen Marwat, and Naseer Ahmed. "Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections." Pakistan Journal of Nuclear Medicine 10 (2020), 13-19. doi:10.24911/PJNMed.175-1568470299


MLA (The Modern Language Association) Style

Ammar, Ayesha, Shazia Fatima, Kahkashan Bahsir Mir, Sadaf Butt, Sadaf Batool, Muhammad Adnan Saeed, Noreen Marwat, and Naseer Ahmed. "Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections." Pakistan Journal of Nuclear Medicine 10.1 (2020), 13-19. Print. doi:10.24911/PJNMed.175-1568470299


APA (American Psychological Association) Style

Ammar, A., Fatima, . S., Mir, . K. B., Butt, . S., Batool, . S., Saeed, . M. A., Marwat, . N. & Ahmed, . N. (2020) Utility of Tc-99m-labeled levofloxacin as an infection-imaging agent in musculoskeletal infections. Pakistan Journal of Nuclear Medicine, 10 (1), 13-19. doi:10.24911/PJNMed.175-1568470299


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