Simultaneous 111In-WBC and 99mTc-SC SPECT/CT Clearly Delineates Infection Sites.

A 22-year-old man sustained a complex left ankle fracture following a motor vehicle collision and underwent external and internal fixation with transfixation-pinning. Several weeks after surgery, the patient presented with clinical concerning for infection at the fracture sites. Initial radiographic evaluation of the left lower extremity showed no evidence of osteomyelitis. The patient underwent SPECT/CT with a novel imaging protocol, using simultaneous acquisition of 111In-WBC and 99mTc- SC SPECT/CT, which clearly delineated the infection sites along the orthopedic hardware track and adjacent soft tissues. This new combined SPECT/CT protocol offers advantages of shorter scanning time, easy patient positioning, expedited diagnostic workup, and more accurate localization of infection sites compared to the conventional protocol of separately acquiring 111In-WBC and 99mTc- SC SPECT/CT images.