Comparison of the accuracy of 99mTC-MDP and 99mTC-SC bone scanning imaging for the diagnosis of chronic osteomyelitis

Abstract

Background There is a lack of effective imaging tools for the clinical confirmation of chronic osteomyelitisis. At present, there are few studies/reports on the diagnosis of chronic osteomyelitisis by nuclear medicine at home and abroad. In this study, we retrospectively observed the accuracy of ^99mTC-MDP and ^99mTC-SC bone scanning imaging for the diagnosis of chronic osteomyelitisis and explored the clinical value of the two nuclear medicine imaging modalities for the diagnosis of chronic osteomyelitisis. Methods Patients who underwent ^99mTC-MDP or ^99mTC-SC bone scan imaging with surgical treatment for suspected chronic osteomyelitisis in our hospital from January 2019 to December 2022 were retrospectively analyzed. They were categorized into the ^99mTC-MDP group and ^99mTC-SC group according to their bone scan imaging modality. The bone scan results were also compared with the postoperative pathology and culture results to clarify the accuracy of the two imaging modalities. Results A total of 72 patients were included, including 38 patients in the ^99mTC-MDP group and 34 patients in the ^99mTC-SC group. A total of 51 patients were diagnosed with chronic osteomyelitisis. Bone scanning imaging in the ^99mTC-MDP group showed positive results in 29 cases and negative results in 9 cases, consistent with the final pathologic diagnosis in 24 cases and inconsistent with the final pathologic diagnosis in 14 cases. Bone scanning imaging in the ^99mTC-SC group showed positive results in 27 cases and negative results in 7 cases, consistent with the final pathologic diagnosis in 29 cases and inconsistent with the final pathologic diagnosis in 5 cases. The sensitivity, specificity, misdiagnosis rate, leakage rate, positive predictive value, negative predictive value, and accuracy of ^99mTC-MDP bone scan for the diagnosis of chronic osteomyelitisis were 80% (20/25), 30.77% (4/13), 69.23% (9/13), 20% (5/25), 68.97% (20/29), and 44.44% (4/9), respectively, 63.16% (24/38); the sensitivity, specificity, misdiagnosis rate, leakage rate, positive predictive value, negative predictive value, and accuracy of ^99mTC-SC bone scan for diagnosing chronic osteomyelitisis were 92.31% (24/26), 62.5% (5/8), 37.5% (3/8), 7.69% (2/26), and 88.89% (24/27), respectively, 71.43% (5/7), 85.29% (29/34). The accuracy of the two tests by chi-square test (2) was 2 = 8.25, P < 0.05, so ^99mTC-SC bone scanning imaging was more accurate than ^99mTC-MDP bone scanning imaging in diagnosing chronic osteomyelitisis. Conclusion Based on the current results, ^99mTC-SC has a higher diagnostic accuracy for chronic osteomyelitisis than ^99mTC-MDP bone scan imaging.