ARRS 2022 Abstracts

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E1227. Blast From the Past: White Blood Cell Labeled and Gallium Scintigraphy in Infection and Inflammation
Authors
  1. Hannah Singhal; Saint Luke's Hospital of Kansas City; University of Missouri- Kansas City
  2. Aman Saini; Saint Luke's Hospital of Kansas City; University of Missouri- Kansas City
  3. Som Singh; University of Missouri- Kansas City
  4. Michael Applebaum; Saint Luke's Hospital of Kansas City; University of Missouri- Kansas City
Background
Infectious and inflammatory conditions are commonly encountered in the field of radiology. However, the use of scintigraphic imaging as a tool to differentiate between conditions has since been usurped with the advent of cross sectional imaging. This educational exhibit will refresh the learner (residents, fellows, and nuclear medicine imaging staff) on the utility of scintigraphy in the setting of infection and inflammation imaging.

Educational Goals / Teaching Points
The goals of this exhibit are to review the exam indication, patient preparation, normal biodistribution of the radiopharmaceutical, and utility of infection/inflammation scintigraphy with Indium-111 (In-111), Technetium-99m hexamethylpropyleneamine oxime (Tc-99 m HMPAO), and Gallium-67 (Ga-67), with pertinent examples. Additionally, imaging findings and relevant clinical data of various infectious and inflammatory etiologies will be presented in a case-based format, with supplementary multi-modality imaging. After review of this exhibit, the learner will be able to confidently identify common abnormalities encountered during infection/inflammation scintigraphy.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Key cases will include but are not limited to: infectious/inflammatory vascular etiologies such as aortitis and infected dialysis grafts; soft tissue infections such as abscesses and cellulitis; bone and joint infections such as osteomyelitis and septic arthritis; other sources of infection such as pneumonia, sinusitis, mastoiditis, and colitis; and additional systemic entities such as metastatic disease and sarcoidosis. The pathophysiology, relevant clinical data, and scintigraphic imaging findings, with correlating multimodality imaging (ultrasound, CT, and MRI) of these various causes will be presented in a case-based format. The normal biodistribution of radiopharmaceuticals, as well as pitfalls in interpretation, will also be reviewed.

Conclusion
Scintigraphic imaging is often underutilized in the setting of various inflammatory and infectious etiologies. Recognizing the utility of scintigraphic studies as a potential problem-solving tool in various clinical scenarios can help increase diagnostic accuracy and streamline future treatment plans to optimize patient care.