Clinical impact of SPECT/CT with In-111 biotin on the management of patients with suspected spine infection

Purpose: Early identification and localization of spine infection is necessary for adequate therapeutic strategy. To localize the precise site of infection we evaluated In-111 Biotin SPECT/CT versus planar and SPECT imaging. Methods: Seventy-two consecutive patients were enrolled and underwent SPECT/CT and planar imaging 2 to 4 hours post i.v. injection of In-111 Biotin. Final diagnosis was based on bacterial cultures and/or clinical/imaging follow-up for at least 1 year. We evaluated the diagnostic performance of planar, SPECT, and SPECT/CT In-111 Biotin scintigraphy. Results: In-111 Biotin SPECT/CT and SPECT showed similar values of sensitivity (93.5% vs. 92.1%) and the same specificity (92.3%), planar imaging showed 80.4% of sensitivity and 69.2% of specificity. In 16 patients SPECT/CT correctly localized the infection site (bone, soft tissue, or both bone and soft tissue). Conclusions: SPECT/CT enhances the impact of In-111 Biotin scintigraphy on the clinical management of patients, allowing the exact site of infection to be localized to select the appropriate therapy.