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J Nucl Med. 2008; 49 (Supplement 1):266P
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General Clinical Specialties: Infectious Disease/Hematology

Infectious Disease/Hematology Posters

In-111 WBC scintigraphy for evaluation of the painful penile prosthesis

Dwight Achong1 and Martin Zloty1

1 Nuclear Medicine Service (115), James A. Haley Veterans' Hospital, Tampa, Florida

1139

Objectives: Evaluation of the painful penile prosthesis may pose a diagnostic challenge for the clinician; differential considerations include infection and neuropathy. In-111-labeled white blood cell scintigraphy (WBCS) is performed routinely for evaluation of fever of unknown origin and soft tissue and bone infection. The utility of WBCS for evaluation of the infected penile prosthesis was retrospectively reviewed.

Methods: Fifteen male patients, age range 42-79 yrs (mean 65 yrs) with a painful penile prosthesis underwent WBCS to evaluate for possible infection. The age of prosthesis at the time of imaging ranged from 1 month to 4.5 yrs (mean 2 yrs). There were 2 rigid, 1 semi-rigid, and 12 inflatable prostheses. Planar imaging of the pelvis in anterior, posterior and oblique projections was performed at 24 hrs in all patients, with additional 48 hr delayed imaging in 6 patients and SPECT imaging in 3 patients.

Results: 11/15 WBCS demonstrated no abnormal WBC activity – the absence of infection was confirmed in all cases based on clinical or post-operative (removal/revision) follow-up. The primary pattern of abnormal WBC accumulation identified was diffuse activity throughout the penile shaft. 4/15 WBCS were abnormal – infection was confirmed in 3/4 cases at the time of surgical removal. One false-positive study, which followed a 3-week course of broad-spectrum antibiotics, demonstrated only very mild diffuse WBC activity. Delayed 48 hour and SPECT imaging were found not to provide additional information over and above that obtained on 24 hour images. 2 cases with no abnormal penile activity did demonstrate bilateral inguinal lymphadenitis.

Conclusions: WBCS is useful in identifying the infected penile prosthesis. Diffuse WBC accumulation throughout the penile shaft is the most common pattern associated with infection.





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Right arrow Articles by Achong, D.
Right arrow Articles by Zloty, M.
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Right arrow Articles by Zloty, M.