Abstract
Technetium (99mTc) labelled, polyclonal human immunoglobulin (HIG) is a new agent that detects focal infection and inflammation. This new agent was compared in 40 patients with the accepted standard, namely111In-oxine-labelled leucocytes. This comparison resulted in a sensitivity of 94% and a specificity of 96% for99mTc-HIG when111In-oxine leucocytes were defined as giving the true result. The new agent was shown to localize both sepsis and active inflammatory bowel disease (IBD). There was 100% concordance in the 16 patients with IBD who were imaged with both99mTc-HIG and111In-oxine leucocytes. Discordant results were obtained in one case of suspected osteomyelitis, which was false-positive on the99mTc-HIG scan, and one case of pyrexia of unkown origin when the99mTc-HIG was false-negative and the111In-oxine leucocyte scan demonstrated accumulation of tracer in the caecum at 24 h post-injection. Normal distribution for99mTc-HIG demonstrated activity in the kidneys and bladder and that 50% of the tracer is cleared through the kidneys during the first 24 h post-injection. There were no major or minor side-effects.
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References
Becker W, Schomann E, Fischbach W, Berner W, Gruner KR (1988) Comparison between99mTc-HMPAO and111In-oxine labelled granulocytes in man: first clinical results. Nucl Med Commun 9:435–447
Blok D, Ogtrop MV, Arndt JW, Camps JAJ, Feitsma RIJ, Pauwels EKJ (1990) Detection of inflammatory lesions with radiolabelled immuno-globulins. Eur J Nucl Med 16:303–305
Claessens RAMJ, Oyen WJG, Broek WJM van den, Corstens FHM, Meer JWM van der (1989) Scintigraphic detection of inflammation sites with In-111 labelled polyclonal human immunoglobulin (IgG). (abstract) Eur J Nucl Med 15:454
Costa DC, Lui D, Ell PJ (1988) White cells radiolabelled with111In and99mTc-HMPAO: a study of relative sensitivity and in vivo viability. Nucl Med Commun 9:725–731
Coakley AJ, Mountford PJ (1986) Indium-111 leucocyte scanning-underused? Br Med J 293:973–974
Datz FL, Thorne DA (1987) Cause and significance of cold bone defects on Indium-111-labelled leukocyte imaging. J Nucl Med 28:820–823
Fischman AJ, Rubin RH, Khaw BA, Callahan RJ, Wilkinson R, Keech F, Nedelman M, Dragotakes S, Kramer PB, LaMuralgia GM, Lind S, Strauss HW (1988a) Detection of acute inflammation with111In-labelled nonspecific polyclonal IgG. Semin Nucl Med 18:335–344
Fischman AJ, Wilkinson R, Khaw BA, Callahan M, Ahmad E, Kocke ND, Nossiff HW, Strauss HW, Rubin RH (1988b) Imaging of localized bacterial infections with radiolabelled nonspecific antibody fragments (Abstract). J Nucl Med 29:887
Hotze A, Briele B, Bockisch A, Ruhlmann J, Moeller F, Ruether W, Biersack HJ (1989) Tc-99m-anti-granulocyte-antibody (AGAB) in orthopedic patients (abstract). Eur J Nucl Med 15:445
Kaps HP, Georgi P, Sinn H (1986) Pitfalls with white blood cell scanning in orthopeadics. In: Schmidt HAE, Ell PJ, Britton KE (eds) Nuclear medicine in research and practice. Schattauer, Stuttgart, pp 150–152
Kroonenburgh MJPG van, Pauwels EKJ (1988) Human immunological response to mouse monoclonal antibodies in the treatment or diagnosis of malignant diseases. Nucl Med Comm 9:919–930
Lamki LA, Kasi LP, Haynie TP (1988) Localisation of Indium-111 leukocytes in noninfected neoplasms. J Nucl Med 29:1921–1926
Lavender JP, Lowe J, Baker JR, Burn JI, Chaudri MA (1971) Gallium-67 citrate scanning in neoplastic and inflammatory lesions. Br J Radiol 44:361–366
Lisbona R, Cassoff J, Angtuaco E, Satin R (1979) Comparative accuracy and complementary use of67Ga-citrate imaging and ultrasound in the diagnosis of abdominal abscesses. Clin Nucl Med 4:108–110
Locher JT, Seybold K, Andreas RY, Schubiger PA, Mach JP, Buchegger F (1986) Imaging of inflammatory and infectious lesions after injection of radioiodinated monclonal anti-granulocytes antibodies. Nucl Med 7:659–670
Lui D, Costa DC, Jarritt PJ, Ell PJ (1988) Simultaneous dual radionuclide labelled white cells: In-111 oxine vs Tc-99m-HMPAO. A comparative study. Nucl Med 24[Suppl]:483–486
McCarthy K, Velchik MG, Alavi A, Mandell Ga, Esterhai JL, Goll S (1988) Indium-111-labelled white blood cells in the detection of osteomyelitis complicated by a pre-existing condition. J Nucl Med 29:1015–1021
Mountford PJ, Kettle AG, Coakley AJ (1989) Detection of intraabdominal sepsis with 4 h99mTc-HMPAO leucocyte images. Nucl Med Comm 10:235–236
Navarro DA, Weber PM, Kang IY, Remedios LV dos, Jasko IA, Sawicki JE (1987) Indium-111 leukocyte imaging in appendicitis. Am J Roent 148:733–736
Peters AM, Roddie ME, Danpure HJ, Osman S, Zacharopoulos GP, George P, Stuttle AWJ, Lavender JP (1988)99Tcm-HMPAO labelled leucocytes: comparison with111In-tropolonate labelled granulocytes. Nucl Med Comm 9:449–463
Pullman W, Hanna R, Sullivan P, Booth JA, Lomas F, Doe WF (1986) Technetium-99m autologous phagocyte scanning: a new imaging technique for inflammatory bowel disease. Br Med J 293:171–174
Reske SN, Zillkens KM, Glockner W, Buell U (1989) Localization of subacute and chronic inflammatory lesions by means of Te-99m labelled murine monoclonal anti-NCA-antibodies (TeNCAA) (Abstract). Eur J Nucl Med 15:455
Rubin RH, Fischman AJ, Callahan RJ, Khaw BA, Keech F, Ahmed M, Wilkinson R, Strauss HW (1989)111In-labelled nonspecific immunoglobulin scanning in the detection of focal infection. N Engl J Med 321:935–940
Saverymuttu SH, Crofton ME, Peters AM, Lavender JP (1983) Indium-111 tropolonate leucocyte scanning in the detection of intra-abdominal abscesses. Clin Radiol 34:593–596
Sayle BA, Balachandaran S, Rogers CA (1983) Indium-111 chloride imaging in patients with suspected abscesses. Concise communication. J Nucl Med 24:1114–1118
Schmidt KG, Ramussen JW, Wedebye IM, Frederiksen PB, Pedersen NT (1988) Accumulation of Indium-111-labelled granulocytes in malignant tumours. J Nucl Med 29:479–484
Schrijver M de, Streule K, Senekowitsch R, Fridich R (1987) Scintigraphy of inflammation with nanometer-sized colloidal tracers. Nucl Med Commun 8:895–908
Seybold K, Locher JT, Coosemans C, Andres RY, Schubiger PA, Blauenstein P (1988) Immunoscintigraphic localization of inflammatory lesions: clinical experience. Eur J Nucl Med 13:587–593
Streule K, De Schrijver M, Fridich R (1988)99mTc-labelled HSAnanocolloid versus111In oxine-labelled granulocytes in detecting skeletal septic process. Nucl Med Comm 9:59–67
Thakur ML, Lavender JP, Arnot RN, Silvester DJ, Segal AW (1977) Indium-111 labelled autologous leukocytes in man. J Nucl Med 18:1012–1029
Thakur ML, Richard MD, White FW (1988) Monoclonal antibodies as agents for selective radiolabelling of human neutrophils. J Nucl Med 29:1817–1825
Wraight EP (1989)99mTc nanocolloid and111In leucocyte scintigraphy in inflammatory bowel disease (abstract). Nucl Med Comm 10:236–237
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Buscombe, J.R., Lui, D., Ensing, G. et al. 99mTc-human immunoglobulin (HIG) — first results of a new agent for the localization of infection and inflammation. Eur J Nucl Med 16, 649–655 (1990). https://doi.org/10.1007/BF00998164
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DOI: https://doi.org/10.1007/BF00998164