European Journal of Nuclear Medicine

, Volume 22, Issue 5, pp 453–464 | Cite as

Technetium-99m antimyosin antibody (3–48) myocardial imaging: human biodistribution, safety and clinical results in detection of acute myocardial infarction

  • Raymond Taillefer
  • Luc Boucher
  • Raymond Lambert
  • Jean Grégoire
  • Denis-Carl Phaneuf
  • Hanna Sikorsa
Original Article


Technetium-99m antimyosin (99mTc-AM) antibody imaging may have significant advantages over indium-111 antimyosin in clinical practice. The purpose of this study was to determine the human biodistribution, the safety profile and the sensitivity of99mTc-AM (3–48) imaging in the detection of both Q-wave and non-Q-wave myocardial infarction (MI). Biodistribution and safety parameters were mainly determined in 12 normal healthy volunteers while 40 patients with proven MI (22 Q-wave, 18 non-Q-wave) were injected with99mTc-AM (20–25 mCi) between 5 h and 7 days after the onset of acute chest pain. Three standard planar views were performed at 6 h and at 24 h post injection. Both sets of images were completed in 33 patients while two patients were imaged only at 6 h, three patients only at 18 h and one at 18 and 24 h. One patient was not imaged. Vital signs and ECG were recorded and blood samples for haematology, biochemistry and human antimurine antibodies (HAMA) and urinalysis were obtained in all volunteers and patients. No serious adverse reactions or side-effects attributable to99mTc-AM have been reported. No volunteers or patients developed allergic reactions or significant increases in HAMA titres. Reading of99mTc-AM imaging was performed by two blinded experienced observers. The sensitivity of99mTc-AM in the detection of MI was 100% (21/21) for Q-wave and 83.3% (15/18) for non-Q-wave infarctions. The overall sensitivity was 92.3% (36/39). The three false-negative cases were inferoposterior MI. A certain degree of uptake focalization was seen in 26 out of 35 (74.2%) at 6 h. At 24 h, two patients (5.8%) did not show99mTc-AM uptake while 22 (64.7%) showed intense focal uptake, seven (20.6%) moderate uptake and 3 (8.9%) slight uptake. It is concluded that99mTc-AM (3–48) imaging is safe and shows high sensitivity in the detection of both Q-wave and non-Q-wave MI even with early imaging (6 h post injection). These promising results warrant further clinical investigation.

Key words

Technetium-99m antimyosin Myocardial infarction 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Khaw BA, Beller GA, Haber E, Smith TW. Localization of cardiac myosin-specific antibody in myocardial infarction.J Clin Invest 1976; 58:439.PubMedGoogle Scholar
  2. 2.
    Beller GA, Khaw BA, Haber E, Smith TW. Localization of radiolabeled cardiac myosin-specific antibody in myocardial infarcts. Comparison with technetium-99m stannous pyrophosphate.Circulation 1977; 55:44–78Google Scholar
  3. 3.
    Khaw BA, Beller GA, Haber E. Experimental myocardial infarct imaging floowing intravenous administration of iodine131 labeled antibody F(ab′)2 fragments specific for cardiac myosin.Circulation 1978; 57:743–750.PubMedGoogle Scholar
  4. 4.
    Khaw BA, Gold HK, Leinbach RC, Fallon JT, Strauss W, Pohost GM, Haber E. Early imaging of experimental myocardial infarction by intracoronary administration of 131-I-labelled anti-cardiac myosin F(ab′)2 fragments.Circulation 1978; 58: 1137–1142.PubMedGoogle Scholar
  5. 5.
    Khaw BA, Fallon JT, Strauss HW, Haber E. Myocardial infarct imaging of antibodies to canine cardiac myosin with indium-111-diethylenetriamine pentaacetic acid.Science 1980; 209:295–297.PubMedGoogle Scholar
  6. 6.
    Khaw BA, Strauss HW, Carvalho A, Locke E, Gold HK, Haber E. Technetium-99m labelling of antibodies to cardiac myosin Fab and to human fibrinogen.J Nucl Med 1982; 23: 1011–1019.PubMedGoogle Scholar
  7. 7.
    Gold HK, Yasuda T, et al. Scintigraphic quantitation of myocardial necrosis in patients after intravenous injection of myosin-specific antibody.Circulation 1986;74: 501–508.PubMedGoogle Scholar
  8. 8.
    Khaw BA, Mattis JA, Melincoff G, Strauss HW, Gold HK, Haber E. Monoclonal antibody to cardiac myosin: imaging of experimental infarction.Hybridoma 1984;3:11–23.PubMedGoogle Scholar
  9. 9.
    Khaw BA, Strauss HW, Cahill SL, et al. Sequential imaging of In-111 labelled monoclonal antibody in human mammary tumors hosted in nude mice.J Nucl Med 1984;25:592–603.PubMedGoogle Scholar
  10. 10.
    Khaw BA, Strauss HW, Moore R, Fallon JT, Yasuda T, Gold HK, Haber E. Myocardial damage delineated by indium-III antimyosin Fab and technetium-99m pyrophosphate.J Nucl Med 1987;28:76–82.PubMedGoogle Scholar
  11. 11.
    Khaw BA, Yasuda T, Gold HK, et al. Acute myocardial infarct imaging with indium-111-labelled monoclonal antimyosin Fab.J Nucl Med 1987;28:1671–1678.PubMedGoogle Scholar
  12. 12.
    Braat SH, DeZwaan C, Teule J, et al. Value of indium-111 monoclonal antimyosin antibody for imaging in acute myocardial infarction.Am J Cardiol 1987;60:725–726PubMedGoogle Scholar
  13. 13.
    Berger H, Lahiri A, Leppo J, et al. Antimyosin imaging in patients with ischemic chest pain: initial results of phase III multicentre trial.J Nucl Med 1988;29:805–806.Google Scholar
  14. 14.
    Johnson LL, Seldin DW, Becker LC, et al. Antimyosin imaging in acute transmural myocardial infarction: results of a multicenter clinical trial.J Am Coll Cardiol 1989;13:27–35.PubMedGoogle Scholar
  15. 15.
    Volpini M, Giubbini R, Gei P, et al. Diagnosis of acute myocardial infarction by indium-111 antimyosin antibodies and correlation with the traditional techniques for the evaluation of extent and localization.Am J Cardiol 1989;63:7–13.PubMedGoogle Scholar
  16. 16.
    Tamaki N, Yamada T, Mastsumori A, et al. Indium-111 antimyosin antibody imaging for detecting different stages of myocardial infarction: comparison with technetium-99m-pyrphosphate imaging.J Nucl Med 1990;31:136–142.PubMedGoogle Scholar
  17. 17.
    Johnson LL, Seldin DW The role of antimyosin antibodies in acute myocardial infarction.Semin Nucl Med 1989;19:328–246.Google Scholar
  18. 18.
    Senior R, Bhattacharya S, Manspeaker P, et al. 99mTc-antimyosin antibody imaging for the detection of acute myocardial infarction in human beings.Am Heart J 1993;126:536–542.PubMedGoogle Scholar
  19. 19.
    Sikorska H, Rousseau J, Desputeau C, et al. Infarcted heart uptake and biodistribution of radiolabelled antimyosin monoclonal antibody in rat and dog myocardial infarct models.J Med Biol 1990;17:567–584.Google Scholar
  20. 20.
    Rousseau J, Sikorska HM, Gervais A, et al. Evaluation of a99mTc-antimyosin kit for myocardial infarct imaging.J Nucl Biol Med 1995. Suppl #3.Google Scholar
  21. 21.
    Addonizio LJ, Michler RE, Marboe C, et al. Imaging of cardiac allograft rejection in dogs using indium-111 monoclonal antimyosin Fab.J Am Coll Cardiol 1987;9:555–564.PubMedGoogle Scholar
  22. 22.
    Carrio I, Berna L, Ballester M, et al. Indium-111 antimyosin scintigraphy to assess myocardial damage in patients with suspected myocarditis and cardiac rejaction.J Nucl Med 1988;29:1893–1900.PubMedGoogle Scholar
  23. 23.
    Nischimura T, Sada M, Sasaki H, et al. Identification of cardiac rejection in heterotopic heart transplantation using 111-Inantimyosin.Eur J Nucl Med 1987;13:343–347.PubMedGoogle Scholar
  24. 24.
    Matsumori A, Ohkusa T, Matoba Y, et al. Myocardial uptake of antibody in a murine model of viral myocarditis.Circulation 1989;79:400–405.PubMedGoogle Scholar
  25. 25.
    Rezkalla S, Kloner RA, Khaw BA, et al. Detection of experimental myocarditis by monoclonal antimyosin antibody Fab fragment.Am Heart J 1989;117:391–395.Coll Cardiol 1989; 13:1289–1293.PubMedGoogle Scholar
  26. 26.
    Yasuda T, Palacios IF, Dec GW, et al. Indium-111 monoclonal antimyosin antibody imaging in the diagnosis of acute myocarditis.Circulation 1987;76:306–311.PubMedGoogle Scholar
  27. 27.
    Jain D, Zaret BL. Antimyosin cardiac imaging: Will it play a role in the detection of doxorubicin cardiotoxicity?J Nucl Med 1990;31:1970–1974.PubMedGoogle Scholar
  28. 28.
    Nishimura T, Nagata S, Uchara T, et al. Assessment of active myocardial cell damage in hypertrophic cardiornyopathy by using In-111-antimyosin Fab myocardial imaging.J Nucl Med 1990;31:782.Google Scholar
  29. 29.
    Obrador D, Ballester M, Carrio I, et al. High prevalence of myocardial monoclonal antimyosin antibody uptake in patients with chronic idiopathic dilated cardiomyopathy.J Am Coll Cardiol 1989;13:1289–1293.PubMedGoogle Scholar
  30. 30.
    Chen LD, Barette RL, Rosenthall L, et al. Clinical application of a new antimyosin antibody.Nuc Compact 1989;20: 150–152.Google Scholar
  31. 31.
    Rhodes BA, Zamoa PO, Newell KD, et al. Technetium-99m labelling of murine monoclonal antibody fragments.J Nucl Med 1986;27:685–693.PubMedGoogle Scholar
  32. 32.
    Sands H, Jones PL. Methods for the study of the metabolism of radiolabeled monoclonal antibodies by liver and tumor.J Nucl Med 1987;28:390–398.PubMedGoogle Scholar
  33. 33.
    John E, Thakur ML, Wilder S, Alauddin MM, Epstein AL. Technetium-99m-labeled monoclonal antibodies: influence of technetium-99m binding sites.J Nucl Med 1994;35:876–881.PubMedGoogle Scholar
  34. 34.
    Lamki LM. Radioimmunoscintigraphy of cancer: problems, pitfalls, and prospects.Nucl Med Ann 1990;113–150.Google Scholar
  35. 35.
    Nedelman MA, Shealy DJ, Boulin R, et al. Rapid infarct imaging with technetium-99m-labeled antimyosin recombinant single-chain Fv: evaluation in a canine model of acute myocardial infarction.J Nucl Med 1993;34:234–241.PubMedGoogle Scholar
  36. 36.
    deBie SH, Ferreira TC, Pownels EKJ, Cleton FJ. Immunoscintigraphy for cancer detection. “A thousand ills require a thousand cures” [guest editorial].J Cancer Res Clin Oncol 1992;181:1–15.Google Scholar
  37. 37.
    Goodwin DA, Pharmacokinetics and antibodies [editorial].J Nucl Med 1987;28:1358–1362.PubMedGoogle Scholar
  38. 38.
    Halpern SE, Dillman RD. Problems associated with radioimmunodetection and possibilities for future solutions.J Biol Response Mod 1987;6:235–262.PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Raymond Taillefer
    • 1
  • Luc Boucher
    • 1
  • Raymond Lambert
    • 1
  • Jean Grégoire
    • 1
  • Denis-Carl Phaneuf
    • 1
  • Hanna Sikorsa
    • 2
  1. 1.Département de Médecine NucléaireHôtel-Dieu de MontréalMontréal, QuébecCanadaCanada
  2. 2.Rougier Bio-Tech Ltd.MontréalCanada

Personalised recommendations