Abstract for presentation at 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 2008

Objective: A 73 year old woman was admitted into Emergency complaining of pain and tenderness in the right axilla accompanied by high fevers. She had an extensive history of peripheral vascular disease with numerous failed axillofemoral graft insertions. Chest CT demonstrated the graft to be patent with a small fluid collection surrounding it at the level of the axilla.
Method: A Tc-99m labelled leucocyte study was requested to confirm the presence of infection at this site.
Result: The SPECT/CT images demonstrated intense leucocyte accumulation around the right axillofemoral graft superiorly. Cultured tissue sampled from the graft confirmed the presence of staphylococcus aureus, consistent with radiological and scintigraphic suspicion of infection.
Conclusion: The case illustrates the important role of SPECT/CT in routine leukocyte imaging. The co-registration of SPECT with low dose CT imaging provides for physiological uptake to be fused with accurate anatomical localisation in one session, thereby reducing a patients radiation burden and time required for imaging while increasing reporting confidence. This method has a promising role in routine leucocyte infection scanning for infected graft sites.