chiniofon and indium-oxine

The clinical use and mechanisms of action of technetium 99m pyrophosphate, gallium 67 citrate, and indium 111 oxine have been presented. The diagnosis of osteomyelitis in the lower extremity can often be made on the basis of clinical, laboratory, and conventional radiographic evaluations. In the case report of diabetic osteolysis, initial evaluations revealed osteomyelitis. The use of scanning involving leukocytes labeled with technetium and indium 111 oxine lessened the possibilities of an osseous infection. Studies show the sensitivity, specificity, and accuracy of scans using leukocytes labeled with indium 111 oxine to be superior to those of any other form of nucleotide imaging, but further clinical research is needed.

Topics: Adult; Diabetes Mellitus, Type 1; Diagnosis, Differential; Foot Diseases; Gallium Radioisotopes; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Organometallic Compounds; Osteolysis; Osteomyelitis; Oxyquinoline; Radionuclide Imaging; Technetium

Radiolabeled blood cells are widely used for both clinical and research studies. In vitro and in vivo studies have shown the tagging process does not significantly affect function. The labeling techniques and clinical uses of labeled leukocytes and platelets are reviewed.

Topics: Abscess; Blood Platelets; Cerebrovascular Disorders; Chromium Radioisotopes; Eosinophils; Fever of Unknown Origin; Graft Rejection; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Leukocyte Count; Leukocytes; Lymphocytes; Organometallic Compounds; Oxyquinoline; Pulmonary Embolism; Radioisotopes; Radionuclide Imaging; Thrombophlebitis; Tropolone

Following the introduction of In-111 oxine as a label for blood cells by McAffee and Thakur in 1976, these procedures have become increasingly important in the practice of nuclear medicine. Of particular interest are studies involving the use of labeled leukocytes for the detection of focal infection. The clinical utility of labeled platelets is less well developed, although the use of platelets to detect the formation of thrombi in blood vessels and on vascular grafts and prostheses is gaining prominence. This report summarizes the techniques presently employed at the University of Minnesota for the labeling of blood products, and their clinical use. Consideration also is given to the desired expertise and cost factors involved in the labeling of leukocytes and platelets.

Topics: Abdomen; Animals; Blood Platelets; Cell Separation; Dogs; Evaluation Studies as Topic; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Kinetics; Leukocytes; Lung Diseases; Organometallic Compounds; Oxyquinoline; Quality Control; Radioisotopes; Radionuclide Imaging; Retroperitoneal Space

The relationship between the rate of 111In-platelet deposition on vascular grafts and subsequent thrombosis has been examined in patients undergoing femoropopliteal by-pass. Sixty-seven patients undergoing femoropopliteal by-pass using vein, Dacron or PTFE were randomized to aspirin plus dipyridamole (ASA/DPM) or placebo. Autologous 111In-platelets were injected in the second postoperative week and Thrombogenicity Index (TI) calculated as the mean daily rise in the ratio of radioactivity graft/contralateral thigh. Graft patency was assessed to 1 year. Mean (+s.e.m.) TI at 1 week in 21 grafts that occluded within 12 months was 0.19 +/- 0.018 compared with 0.07 +/- 0.009 in the 38 that remained patient (P less than 0.001). Grafts with a TI less or greater than the median had a 90 per cent or 39 per cent cumulative 1-year patency, respectively (P less than 0.001). In the prosthetic grafts ASA/DPM reduced mean TI from 0.17 +/- 0.02 to 0.11 +/- 0.01 (P less than 0.02) and enhanced 1-year patency from 36 to 67 per cent (P less than 0.05). Following femoropopliteal by-pass TI related to subsequent graft patency. Radiolabelled platelet deposition therefore provides a guide as to how new materials or antithrombotic drugs may influence clinical graft thrombosis. Platelet inhibition reduced both graft thrombogenicity and subsequent occlusion.

Topics: Aspirin; Blood Platelets; Blood Vessel Prosthesis; Dipyridamole; Double-Blind Method; Drug Combinations; Female; Femoral Artery; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Popliteal Artery; Postoperative Complications; Radioisotopes; Risk; Thrombosis

Untreated patients with Hodgkin's disease (HD) have a blood T-lymphocytopenia mainly caused by a reduction of the CD4+ subset. Indirect support for a sequestration of T cells in the spleen and tumor-involved lymphoid tissue has accumulated. To test the hypothesis that the blood CD4 T-lymphocytopenia in patients with HD is caused by an altered lymphocyte traffic, 12 untreated HD patients and five in complete clinical remission (CCR) were studied. Blood lymphocytes were collected by leukapheresis and gradient centrifugation, and were further purified by an adherence step. The cells were labeled with indium-111 oxine and reinfused intravenously into the patient. The radioactivity of CD4+ and CD8+ blood lymphocytes separated by immunoabsorption was measured from serial blood samples. CD4+ cells were eliminated more rapidly in untreated patients than patients in CCR. Repeated gamma camera imaging after autotransfusion of indium-111 oxine labeled cells demonstrated an accumulation of radioactivity in tumor-involved tissue of untreated patients. These findings support the concept of an enhanced elimination of CD4+ cells in patients with active HD that may contribute to the observed blood T-lymphocytopenia and may reflect a biologic response to the tumor.

Topics: Adolescent; Adult; Aged; Antigens, Differentiation, T-Lymphocyte; CD4-Positive T-Lymphocytes; CD8 Antigens; Female; Hodgkin Disease; Humans; Hydroxyquinolines; Indium Radioisotopes; Lymphocyte Depletion; Male; Metabolic Clearance Rate; Middle Aged; Organometallic Compounds; Oxyquinoline; T-Lymphocytes; T-Lymphocytes, Helper-Inducer; T-Lymphocytes, Regulatory

We present a case of emphysematous gastritis initially detected with 111In oxine-labeled white blood cell scintigraphy and subsequently confirmed by computed tomography. Early aggressive antibiotic and supportive therapy resulted in a successful clinical outcome.

Topics: Emphysema; Female; Gastritis; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Middle Aged; Organometallic Compounds; Oxyquinoline; Pancreatitis; Radionuclide Imaging

Intravascular aggregation in response to ADP, thrombin, arachidonate and collagen has been studied in the rat with a view to throwing more light on the validity, the reproducibility and physiology of the model. The radioisotopic technique of labelling platelets with indium-111 oxine was employed. The model is minimally invasive and involves collecting blood from donor rats, separating and labelling their platelets with indium-111 oxine and assessing the accumulation of platelets in the lungs of recipient rats following the intravascular administration of aggregating agents. Of the parameters evaluated, percentage peak increase in radio-labelled platelet count and area under the curve are good parameters of expressing aggregatory responses. Of the visceral organs evaluated, the lung is the most important organ for assessing platelet accumulation. Of the vascular routes examined, no aggregatory response occurred in the lungs when ADP was injected via any of the intra-arterial routes, and of the intravenous routes, injection via the tail vein gave the highest response. The results of this investigation provide some more detailed technical information to take note of when studying platelet aggregation in vivo by this model. The results also highlight the physiological phenomenon involved.

Topics: Adenosine Diphosphate; Animals; Arachidonic Acid; Arachidonic Acids; Blood Platelets; Dose-Response Relationship, Radiation; Hydroxyquinolines; Indium Radioisotopes; Isotope Labeling; Lung; Male; Organometallic Compounds; Oxyquinoline; Platelet Aggregation; Radionuclide Imaging; Rats; Rats, Inbred Strains; Reproducibility of Results; Thrombin

Technetium-99m-HM-PAO [( 99mTc]HM-PAO) leukocyte and indium-111-oxine (111In-oxine) leukocyte scanning were carried out simultaneously in 41 patients at 4 hr and 24 hr after reinjection to determine whether the 4-hr 99mTc scan could replace the 24-hr 111In scan for detecting intraabdominal sepsis. Abdominal infection was confirmed in 12 cases. The 4-hr 99Tc-leukocyte scan, the 4-hr 111In-leukocyte scan, and the 24-hr 111In-leukocyte scan yielded a sensitivity of 100%, 67%, and 100%, respectively, and a specificity of 62%, 90%, and 86%, respectively. The 24-hr 99mTc-leukocyte scan also produced a sensitivity of 100%, but it was falsely positive in all 29 cases without infection due to physiologic bowel uptake. False-positive 4-hr 99mTc-leukocyte scans were also produced by physiologic bowel uptake in seven cases all of whom had true-negative 4-hr and 24-hr 111In-leukocyte scans. Because of the high incidence of false-positive 4-hr [99mTc]HM-PAO leukocyte scans, it was concluded that they could not replace 24-hr 111In-leukocyte scans for detecting intraabdominal sepsis, and that serial 99mTc leukocyte scans starting earlier than 4 hr after reinjection must be evaluated.

Topics: Abdomen; Bacterial Infections; False Positive Reactions; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Organotechnetium Compounds; Oximes; Oxyquinoline; Radionuclide Imaging; Technetium Tc 99m Exametazime; Time Factors

Bacterial sepsis, a significant complication of chronic hemodialysis, is generally the result of infection at the vascular access site. We retrospectively reviewed the utility of indium-111-(111In) labeled autologous leukocyte scintigraphy in 26 patients (30 scans) with synthetic vascular grafts, on chronic hemodialysis, in whom hemodialysis access site infection was a diagnostic consideration. Leukocyte scintigraphy correctly identified all fifteen access-site infections; there was one false-positive study, for an overall sensitivity and specificity of 100% and 93%, respectively. Of particular significance is the fact that in nine (60%) of the fifteen access-site infections, physical examination was normal. Our data indicate that 111In-labeled leukocyte scintigraphy is a useful procedure for the diagnosis of hemodialysis access-site infection, and it is especially valuable when physical examination of the access site is normal.

Topics: Adult; Bacterial Infections; Blood Vessel Prosthesis; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Polytetrafluoroethylene; Radionuclide Imaging; Renal Dialysis; Retrospective Studies

We have studied the clinical utility of indium 111 autologous leucocyte scintigraphy retrospectively in 45 patients presenting with suspected intra-abdominal sepsis. The sensitivity was 95% (21/22) and the specificity was 91% (21/23). Some 34 of the studies (17 positive and 17 negative) were considered helpful in furthering patient management (76%) and 8, unhelpful (18%). In 3, the study results were misleading and led to inappropriate treatment. Indium 111 scintigraphy, whether positive or negative, provides information in patients with suspected intra-abdominal sepsis upon which therapeutic decisions can be based.

Topics: Abdomen; Abscess; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Peritonitis; Radionuclide Imaging

Twelve patients with a clinical diagnosis of possible vascular graft infection have been studied over the last 3 years. All patients had their leucocytes labelled with indium-111 and gamma-camera imaging after 24 and 48 h. Subsequent management was according to established surgical techniques. Eight patients proved to have vascular graft infection and indium uptake was seen along the length of the graft in six. Two patients with open wound infections and synthetic grafts had localized uptake only on leucocyte scanning. Four patients, all of whom had negative scans were not thought to have infected grafts after further investigation using digital subtraction angiography and computed tomography scanning. These patients have been followed up for a median period of 19 months (range 5-25 months) and have remained symptom free. Initial experience with 111In-labelled leucocyte scanning has been encouraging, both in diagnosis and in planning the management of patients with graft infections.

Topics: Bacterial Infections; Blood Vessel Prosthesis; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

The authors elaborated their own modification of the separation and labelling of autologous thrombocytes by means of 111indium-oxine which can be implemented in Czechoslovak departments of nuclear medicine with standard equipment. A total of 123 separations and labellings were made and 85 administrations to patients. The effectiveness of labelling by the described method was 79.5 +/- 6.9%, the separation yield of thrombocytes with regard to complete blood 44.3 +/- 13.8%. The aggregating capacity of the labelled platelets assessed in vitro after ADP stimulation (adenosine diphosphate) was 39.5 +/- 10.1% difference in optic density of platelet rich and platelet poor plasma which is evidence of the preserved viability of thrombocytes. "Recovery" during the 120th minute after administration of normal suspensions was 62.2 +/- 17.9%, the survival time of labelled thrombocytes 8.2 +/- 0.74 days. In patients with idiopathic thrombocytopenic purpura the "recovery" was 49.4 +/- 18%, the survival period 2.9 +/- 1.8 days. In patients after transplantation of the kidney complicated by acute rejection there was an increased accumulation of labelled platelets in the area of the kidney (count rate index 2.32 +/- 0.45). In normally functioning transplanted kidneys the count rate index was 1.42 +/- 0.06. On their own material the authors demonstrate other possibilities of clinical application of scintigraphy by means of labelled autologous platelets (a method hitherto not described in the Ccezhoslovak literature) for the detection of intracardial and arterial thrombosis.

Topics: Blood Platelets; Female; Humans; Hydroxyquinolines; Male; Middle Aged; Organometallic Compounds; Oxyquinoline

The in vivo migration of [111In]oxine-labeled peripheral mononuclear cells (PMNC) was studied in 20 patients with various lymphatic malignancies and palpable enlarged lymph nodes. The maximal labeling dose of 10 microCi (0.37 MBq) [111In]oxine/10(8) PMNC was found not to adversely influence either cell viability or lymphocyte proliferation in vitro. For in vivo studies, 1.5 X 10(9) PMNC were gained by lymphapheresis and reinjected intravenously after radioactive labeling, 150 microCi (5.55 MBq). The labeling of enlarged palpable lymph nodes was achieved in three out of three patients with Hodgkin's disease and in five out of five with high-malignant lymphoma, whereas three out of seven patients with low malignant lymphoma and no patient with chronic lymphatic leukemia had positive lymph node imaging. We thus conclude that PMNC retain their ability to migrate after [111In]oxine labeling and that these cells traffic to involved lymph nodes of some, but not all hematologic malignancies.

Topics: Adult; Aged; Aged, 80 and over; Cell Movement; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Isotope Labeling; Leukemia, Lymphocytic, Chronic, B-Cell; Lymph Nodes; Lymphocyte Activation; Lymphocytes; Lymphoma; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

In a continuing evaluation of 111In-oxine labelled leucocyte imaging in vascular surgery, we have studied 16 patients with a clinical diagnosis of possible vascular graft infection. We have evaluated both visual and semi-quantitative analysis of the images obtained and have interpreted these in the light of the subsequent clinical outcome. Full length or multifocal uptake was seen in six patients, all of whom eventually required graft excision with two limbs surviving, and one death. These patients had a significantly higher uptake ratio (median = 3.26) than those with either localized (median = 1.12; p = 0.0027) or negative images (median = 0.72; p = 0.0003). Of four patients showing localized uptake only, one required amputation for continuing sepsis. Six patients had negative images, and had normal DSA and CT scans. Uptake ratios could not distinguish between those with localized images and those with negative images. Computer generated vertical profiles aided separation of patients with presumed localized and negative images. Semi-quantitative analysis has proved to be a reliable method which should allow a more direct comparison of the efficacy of various investigative techniques and of the results of therapy, independent of intra-observer subjective bias.

Topics: Aged; Blood Vessel Prosthesis; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Prospective Studies; Radionuclide Imaging; Surgical Wound Infection

The dose to a young infant cared for by a parent re-injected with 111In-leucocytes was estimated from the exposure of thermoluminescent dosimeters at five sites on the chest wall of eight patients. The UK Guidance Notes recommend that patients with a residual activity exceeding 20 MBq of 111In should avoid non-essential contact with children. The results confirmed those of an earlier preliminary study which showed that re-injection of 20 MBq of 111In-leucocytes to a parent could lead to a close contact dose greater than 1 mSv. It was concluded that the 111In-leucocyte activity administered to a parent of a young infant should not exceed 10 MBq.

Topics: Adult; Aged; Family; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Infant; Leukocytes; Male; Maximum Allowable Concentration; Middle Aged; Organometallic Compounds; Oxyquinoline; Radiation Dosage; Thermoluminescent Dosimetry

Indium-111 oxine label erythrocytes are useful in scintigraphic studies of splenic function because of the high yield of gamma-photons [172(90%) and 247(94%) keV] of indium-111. However, the effects of indium-111 oxine on the structural and functional integrity of erythrocytes which might influence their reticulo-endothelial (RE) sequestration are unknown. We examined the morphology of human and rat indium-111 labeled erythrocytes by SEM, the distribution of the label within the cell by analysis of the membrane and cytosol (hemoglobin solution) and the kinetics of efflux of indium-111 from erythrocytes incubated at 37 degrees C in plasma or physiological buffer. Indium-111 oxine labeled red cells retain their discocytic morphology and the cell indices, and density characteristics on phthalate ester are similar to those of the control cells. The efficiency of labeling may be as high as 97%. Human or rat erythrocyte membranes retain 33 and 41% of indium-111, and the cytosol contains 67 and 59%, respectively. About 98% of the indium-111 is bound to the membrane proteins and 1% to the lipid bilayer. Efflux of indium-111 from cells in autologous plasma showed a multiphasic release resulting in about 4-5% release of the label in 2 h and 11.5% in 20 h. Cells in PBS showed 1-5% release of the label during the incubation period. These findings suggest that indium-111 oxine labeling of erythrocytes does not grossly alter the structural and deformability integrity of the cells to induce selective RE sequestration, unless the cells have been damaged prior to or during the labeling procedure, or the spleen is hyperactive.

Topics: Animals; Erythrocytes; Humans; Hydroxyquinolines; In Vitro Techniques; Isotope Labeling; Microscopy, Electron, Scanning; Organometallic Compounds; Oxyquinoline; Rats

Topics: Adult; Appendicitis; Child; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Intracardiac thrombi can be localized and quantified by Indium-111-labelling of thrombocytes with a high sensitivity and specificity. The scintigraphic procedure has a complementary evidence to echocardiography. Scintigraphy shows activity and age of thrombosis, whereas echocardiography seems to be superior in determination of mass and localization. In older thrombi scintigraphy fails because of organisation and endothelialization of the thrombus surface. For the reason of determination of the age of an intraventricular thrombus this method might have an increasing acceptance.

Topics: Aged; Blood Platelets; Coronary Disease; Coronary Thrombosis; Heart Ventricles; Humans; Hydroxyquinolines; Indium Radioisotopes; Male; Myocardial Infarction; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Recurrence

Eighteen patients with postinfarction left ventricular aneurysms (LVAs) were examined with Indium-111-labeled autologous platelet scintigraphy to identify intracardiac thrombi and to investigate the effect of antithrombotic agents on thrombogenesity within their LVAs. Left ventriculography (LVG), and two-dimensional echocardiography were also carried out to assess the diagnostic ability of the platelet imaging. Indium-111-platelet scintigraphy for the detection of LVA mural thrombi had a sensitivity of 60% and a specificity of 100%. Four of six patients with false-negative scintigraphic studies had been under antiplatelet therapy. Eight of the nine patients who had showed active platelet deposition on initial examination had not received antiplatelet therapy. Thereafter, five of these nine were treated with tichlopidine (300 mg/day) for 29.8 +/- 5.0 days. On the second platelet study, two had resolution and the other three had interruption of intra-aneurysmal deposition, which remained positive. In only one patient of the three, the third platelet study was performed after warfarin therapy. It took two weeks after beginning the therapy to completely interrupt platelet deposition within the LVA in this patient. ECG gated radionuclide ventriculography and Thallium-201-myocardial scintigraphy were also performed to assess left ventricular wall motion of left ventricular ejection fraction (LVEF) and myocardial blood perfusion. Thallium-201-SPECT showed apical or anteroapical perfusion defects and the radionuclide ventriculography correctly identified all 18 apical and anteroseptal aneurysms which were confirmed by LVG methods. The comparison between the thrombus positive group and the thrombus negative group was carried out on both the LVEF and the period from the last myocardial infarction to the initial platelet scanning study. There were no statistical differences in the LVEF and the interval (34.5 +/- 12.5% vs 37.3 +/- 14.6%, 39.6 +/- 52.6 days vs 89.6 +/- 108.3 days) between the two groups. These results suggest that Indium-111-labeled platelet scintigraphy can be a reliable method for the identification of active left ventricular mural thrombi and a practical method of judging antiplatelet and anticoagulant therapy.

Topics: Adult; Aged; Blood Platelets; Evaluation Studies as Topic; Heart Aneurysm; Humans; Hydroxyquinolines; Indium Radioisotopes; Male; Middle Aged; Myocardial Infarction; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Thrombosis

In order to detect the infectious foci in a case of terminal recurrent cancer of the sigmoid colon with intense inflammation, In-111 oxine leukocyte scintigraphy was performed. Leukocytes labeled with In-111 oxine quickly localized within the region of peritonitis carcinomatosa and could be imaged after 4 hours. With time, high activity appeared in this area. And 48 hours after injection, the large intestine was clearly seen. However, no activity was seen in the main recurrent tumor. This suggested that the labeled leukocytes had accumulated in regions of inflammation rather than in malignant tissue. When performing In-111 leukocyte scintigraphy for diseases in which tumor cells and inflammation are mixed, distinguishing the two components is particularly important, and time-sequential scanning is very useful.

Topics: Adenocarcinoma, Papillary; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Middle Aged; Organometallic Compounds; Oxyquinoline; Peritonitis; Radionuclide Imaging; Sigmoid Neoplasms

The dynamic behavior of indium-111 oxine-labeled leukocytes was simultaneously recorded in multiple organs during endotoxin shock in sheep. Also, the effects of the beta-2 receptor agonist terbutaline were studied. An experimental protocol was designed to mimic a clinical condition in an intensive care setting as far as possible. The animals were ventilated with 50% oxygen to avoid hypoxemia and were given large amounts of intravenous fluids to reduce adverse effects of hypovolemia. A moderate dose of E. coli endotoxin (10 micrograms/kg bwt) was given by intravenous infusion to 14 adult sheep, seven of them receiving continuous intravenous infusion of terbutaline (20 micrograms/kg/hr) during 4 hr, starting 30 min after endotoxin, when signs of lung injury had developed. The other seven acted as controls. A marked pulmonary and hepatic leukocyte sequestration together with a sharp drop in leukocyte counts in peripheral blood occurred within minutes after start of the endotoxin infusion in both groups. However, no changes were observed in the kidneys or the gut. After 60 min and until the end of the experiment, there was a significantly lower activity in the lungs and in the liver of the animals treated with terbutaline than in the controls (P less than .01). Furthermore, less marked hemodynamic and respiratory alterations occurred in the terbutaline group compared with the controls. This study confirms the results of other investigators showing that significant leukocyte sequestration occurs in the lungs during endotoxemia, but it also demonstrates that leukocytes sequestrate in the liver, although slightly less than in the lungs.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adrenergic beta-Agonists; Animals; Endotoxins; Escherichia coli; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Liver; Lung; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Sheep; Shock, Septic; Terbutaline

Topics: Crohn Disease; Granulocytes; Humans; Hydroxyquinolines; Leukapheresis; Leukocyte Count; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Radionuclide Imaging

In three patients with fever of unknown etiology, an Indium-111-Oxine WBC (White blood cell) scan was performed, in order to detect occult sites of inflammation. An intra-abdominal abscess was located in two cases, while in the third the negative result of the scan directed the diagnosis to other systemic pathologies.

Topics: Abscess; Adenocarcinoma; Adult; Aged; Aged, 80 and over; Colonic Neoplasms; Connective Tissue Diseases; Female; Fever of Unknown Origin; Humans; Hydroxyquinolines; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Rectal Diseases

The biological effects of [111In]oxine, [111In]citrate, and [114mIn]citrate localized in mouse testes as well as the effects of external x-rays are investigated. The in vivo radiotoxicity of [111In] oxine is far greater than the chemotoxicity of oxine. Of these radiolabeled compounds, [111In] oxine is the most effective in reducing the sperm-head population, the mean lethal dose (D37) to the organ being about 0.16 Gy at 37% survival of the sperm heads. The corresponding values of D37 for [111In]citrate, [114mIn]citrate and x-rays are approximately 0.34, 0.57, and 0.67 Gy, respectively. The present results affirm our earlier finding of the inadequacy of conventional dosimetry in estimating the biologic consequences of Auger-electron emitters in vivo. The very different radiotoxicities of [111In]oxine and [111In]citrate draw attention to the role of the chemical nature of the radiolabeled compounds in the expression of biologic effects in vivo, an aspect that is not considered explicitly in the formulation of conventional dosimetry.

Topics: Animals; Citrates; Citric Acid; Hydroxyquinolines; Indium Radioisotopes; Male; Mice; Organometallic Compounds; Oxyquinoline; Sperm Head; Testis

The radiopharmaceutical use of [111In]oxine for radiolabeling of blood products has recently met with FDA approval. The molecular structure of tris(8-quinolinolato) indium(III), "indium oxine", was determined by x-ray crystallography using a single yellow crystal grown from ethanol solution. The structural study reveals an asymmetric pseudo-octahedral N3O3 metal coordination sphere with meridional stereochemistry. This asymmetry is not detected in solution by proton NMR spectroscopy at room temperature; however, at -90 degrees C spectroscopic changes suggest slowing of a fluxional process. The molecule unexpectedly crystallized with a molecule of ethanol hydrogen-bonded to an oxygen atom of one of the oxine ligands, suggesting that hydrogen-bonding will play a role in the solvation of this complex in protic solvents.

Topics: Chemical Phenomena; Chemistry; Hydroxyquinolines; Indium Radioisotopes; Organometallic Compounds; Oxyquinoline

Gamma-camera imaging after injection of radiolabelled autologous leucocytes can be very helpful in the diagnosis, localization and further clinical treatment of inflammatory diseases. We present a technique allowing sterile separation of white blood cells and labelling with 99mTc-phytate or -oxine and with 111In-oxine, -oxine sulphate or -tropolone. The method is non-invasive and the radiation dose amounts to less than 80 mrad using 100 microCi 111Indium. The use of radiolabelled granulocytes is of particular diagnostic value in patients with septicaemia of unknown origin. Whole body scanning allows not only visualization of enhanced splenic uptake in septicaemia, but also localization of an inflammatory process. Preferential indications for a diagnostic approach using radiolabelled granulocytes are inflammatory abdominal processes which cannot easily be documented by means of other non-invasive techniques, such as inflammatory bowel disease (Crohn's diseases and ulcerative colitis), arthritic processes and abscesses of the liver and spleen, as well as subphrenic and retroperitoneal abscesses. Untreated osteomyelitis can be located with the help of labelled granulocytes, but in patients treated with antibiotics a false negative result is obtained in approximately 50% of cases for as yet unknown reasons, even in the presence of a still active osteomyelitic process.

Topics: Abscess; Aged; Bacterial Infections; Diagnosis, Differential; Female; Granulocytes; Humans; Hydroxyquinolines; Indium Radioisotopes; Male; Middle Aged; Organometallic Compounds; Organotechnetium Compounds; Osteomyelitis; Oxyquinoline; Peritonitis; Phagocytosis; Radionuclide Imaging; Subphrenic Abscess; Surgical Wound Infection; Technetium

Current methods of 111In chelate conjugation labeling of antibodies expose the protein to pH 5-6 during 111In chelation. These conditions could be detrimental if the antibody is acid labile. We have successfully labeled human IgG via the cyclic anhydride of DPTA and 111In-oxyquinoline(oxine). Chelation was achieved at pH 6.9-8.4 and was complete within 1 min at room temperature. The chelation was sensitive to trace metal contamination on labware and in some reagents (including commercial 111In-oxine).

Topics: Humans; Hydroxyquinolines; Immunoglobulin G; Indium Radioisotopes; Isotope Labeling; Organometallic Compounds; Oxyquinoline; Pentetic Acid

The distribution of [111In]oxine-labeled leukocytes was studied by whole-body gamma camera imaging in nine pediatric patients. Images were obtained at approximately 24 hr after administration of the material. Organ distribution was estimated from stored data by manual region of interest assignment. Dosimetry estimates based on geometric mean and conjugate view absolute activity calculations showed close agreement in these patients. Leukocytes were distributed in liver, spleen and marrow. The mean percent uptakes +/- s.d. were: spleen, 31.2 +/- 18.3%; liver, 26.3 +/- 10.8%; and marrow, 14.2 +/- 5.7%. A significant portion (28.3 +/- 9.9%) of administered white cell activity was found outside these organs in the remainder of the body. Mean organ absorbed doses (rad/mCi) were: spleen, 115.0 +/- 84.8; liver, 13.9 +/- 7.8; marrow, 7.6 +/- 3.8; and total body 2.5 +/- 1.0. The mean organ absorbed doses (rad/dose administered) were: spleen, 13.7 +/- 10.6; liver, 1.48 +/- 0.62; marrow, 0.79 +/- 0.26; and total body, 0.28 +/- 0.09.

Topics: Adolescent; Bone Marrow; Child; Child, Preschool; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Infant; Leukocytes; Liver; Male; Organometallic Compounds; Oxyquinoline; Pediatrics; Radiation Dosage; Spleen

111Indium autologous mixed leucocyte scanning has recently been used for the investigation of Crohn's disease. Nineteen patients had indium scans to assess disease extent and activity. The scans were compared with conventional imaging techniques and indices of disease activity including clinical scores, ESR, CRP, and GI protein loss. In five patients with active disease the scans were negative and overall there was poor correlation between the scan scores and the other indices of disease activity. Indium scanning correctly located extent of disease in only 58% of patients. 111Indium mixed leucocyte scanning may be more suited for the assessment of disease extent and activity in severely ill patients with Crohn's disease.

Topics: Adolescent; Adult; Crohn Disease; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Fifty-seven investigations of the skeletal system were performed on 54 patients, using a 99Tcm-labelled nanometer-sized HSA colloid in a crossover comparison with 111In oxine-labelled granulocytes for the detection of sites of infection. The findings were in agreement in 55 out of 57 investigations (96.5%). Based on 44 studies in which a final clinical diagnosis was obtained, both methods were found to display the same specificity (93%), whilst the sensitivity of 99Tcm nanocolloid scintigraphy (87%) was slightly higher than that obtained with 111In leucocyte scintigraphy (81%). In our opinion, 99Tcm nanocolloid is easier to use and the total duration of the investigation is considerably shorter. The use of 99Tcm is scintigraphically more advantageous and, with the dosage required, the absorbed radiation dose to the red bone marrow is three times lower than with 111In granulocytes. For the detection and therapy monitoring of osteomyelitis, as well as for the investigation of arthroplasties suspected of infective loosening, we consider scintigraphy with 99Tcm nanocolloid to be equivalent to leucocyte scintigraphy. Identical findings were obtained with both tracers in suspected spondylodiscitis.

Topics: Female; Granulocytes; Hip Prosthesis; Humans; Hydroxyquinolines; Indium Radioisotopes; Intervertebral Disc; Knee Prosthesis; Male; Middle Aged; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Prosthesis Failure; Radionuclide Imaging; Spondylitis; Technetium Tc 99m Aggregated Albumin

Topics: Blood Platelets; Humans; Hydroxyquinolines; Indium; Indium Radioisotopes; Isotope Labeling; Organometallic Compounds; Oxyquinoline

The in vitro and in vivo behaviour of 99Tcm-HMPAO (hexamethylpropyleneamineoxime) (n = 12) and 111In-oxine (n = 11) labelled granulocytes, isolated by density-gradient centrifugation (Metrizamide/plasma gradients), was compared in patients with suspected inflammatory diseases. The in vitro elution of both labels and the viability of the labelled cells (99Tcm, 98.5%; 111In, 96.5%) was comparable but the labelling efficiency was different (99Tcm, 44 +/- 13%; 111In, 72.5 +/- 5.5%). In vivo, the lung (t1/2 max: 7.7 min), liver and spleen perfusion patterns were nearly identical; the image quality for detail in 99Tcm scans was superior to 111In images. The blood disappearance curves of 99Tcm and 111In were comparable. In the small number of patients examined all infections could be diagnosed correctly, without false-positive or false-negative results. Disadvantageous is the renal excretion of 99Tcm complexes (3+% over 20 h) with kidney and bladder activity from the beginning of the study. The biliary excretion in half of the patients (n = 6) with unspecific positive small and large bowel visualization and the late intestinal excretion also render the diagnosis more difficult. The recommended best imaging times for abdominal and retroperitoneal inflammations are 30 min to 2 h after injection. Late scans in septic prosthetic joints have disproportionate long acquisition times. As a potential cell labelling compound, 99Tcm-HMPAO has a promising future in comparison to 111In scans because of the good availability of 99Tcm, the image quality and the lower radiation exposure to the patient when lower activities for the early diagnosis of abdominal inflammatory diseases are reinjected.

Topics: Colitis, Ulcerative; Crohn Disease; Female; Granulocytes; Humans; Hydroxyquinolines; Indium Radioisotopes; Inflammation; Isotope Labeling; Joint Diseases; Lung Diseases; Male; Organometallic Compounds; Oximes; Oxyquinoline; Polycystic Kidney Diseases; Radionuclide Imaging; Technetium; Technetium Tc 99m Exametazime

The thrombogenicity of argon laser-assisted vascular anastomoses (LAVAs) was compared with that of sutured vascular anastomoses (SVAs) by measurement of platelet aggregation at the site of repair in a canine model. Sequential 1 cm longitudinal carotid and femoral arteriotomies (n = 80) or jugular and femoral phlebotomies (n = 80) were performed, with each vessel having two tandem, randomly positioned arteriotomies or phlebotomies separated by a 4 cm length of intact vessel. One incision was repaired by SVA with continuous 6-0 polypropylene sutures and the other by argon LAVA. For the laser fusions, argon laser energy was applied to the adventitial surface of the vessel with a 300 micron fiberoptic probe with 0.5 W power, 1100 joules per square centimeter energy fluence, and 150 second exposure per 1 cm length. The arterial and venous segments of SVAs and LAVAs and an equivalent length of normal vessel were harvested at 48 hours (n = 16, 16, 16), 2 weeks (n = 12, 12, 12), and 4 weeks (n = 12, 12, 12). Autologous indium 111 oxine-labeled platelets were injected intravenously 48 hours before removal of the vascular repairs and the radioactivity of the specimens was determined on removal with a NaI (T1) well-type scintillation counter. Anastomotic platelet adherence index (APAI) was calculated as the ratio of emissions of SVA or LAVA to normal reference vessel.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Anastomosis, Surgical; Animals; Carotid Arteries; Dogs; Evaluation Studies as Topic; Femoral Artery; Femoral Vein; Hydroxyquinolines; Indium Radioisotopes; Jugular Veins; Laser Therapy; Models, Biological; Organometallic Compounds; Oxyquinoline; Platelet Aggregation; Radionuclide Imaging; Random Allocation; Suture Techniques; Time Factors; Vascular Patency; Vascular Surgical Procedures

Earlier clinical studies revealed that in patients suffering from chronic osteomyelitis (n = 10) undergoing antibiotic therapy the white blood cell scanning missed the right diagnosis in 40% of cases, whereas all the acute untreated cases (n = 6) were imaged correctly. Thus, it was suspected that an impaired labelling efficiency and white blood cell function might have been causative. Retrospective analysis of labelling efficiency exhibited no difference between patients on antibiotics (n = 12) and those not on antibiotics (n = 29). Prospective cellular viability testing in 81 patients, 71 of whom were on various antibiotics, using latex particles (phagocytosis) and the Trypan blue exclusion test, did not reveal any different function behaviour either. Examining the labelling efficiency (after 111In-oxine and 111In-oxine-sulphate labelling), recovery, half-life and viability of white blood cells of 107 patients undergoing therapy with various antibodies as compared to controls, it becomes evident that the antibiotic therapy is not causative of the clinical difference observed.

Topics: Adult; Aged; Anti-Bacterial Agents; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Isotope Labeling; Leukocytes; Male; Middle Aged; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Radionuclide Imaging

Since the fibrinolytic system of the swine is close to that of human, the use of a swine model may assume increasing prominence in future studies of thrombosis. Swine platelets were labeled with 111In in a modified Tyrode's solution, suspended in plasma, then injected intravenously into swine. The average radioactivity incorporated into the platelets was 44 +/- 27%. The recovery of labeled platelets at 5 minutes post-injection was 81.7 +/- 5.3%. The platelets retained their label throughout their life span. The survival of 111In-platelets was described by a one component exponential equation, with a life span of 157.9 +/- 25.3 hrs.

Topics: Animals; Blood Platelets; Cell Survival; Hydroxyquinolines; Organometallic Compounds; Oxyquinoline; Swine; Time Factors

It has shown that, after intravenous administration of autologous lymphocytes labelled with the beta-emitting radionuclide 114Inm, the cells initially migrate normally before succumbing to the toxic effects of the radiation. The radioactive material is then released from the cell and taken up by neighbouring radioresistant macrophages, thereby localizing a field of radiation to the site of lymphocyte death. Using this technique, lymphocytopoenia has been produced in rats. We have measured the whole-body distribution and excretion of radioactivity in patients who received escalating activities of 114Inm-labelled lymphocytes. All patients had active non-Hodgkin's lymphoma involving the spleen and liver which proved resistant to combination chemotherapy and conventional radiotherapy. Following intravenous administration, the labelled cells cleared rapidly from the vasculature with only 15% remaining in the peripheral blood at 30 min. The radioactivity continued to fall over the next 5 days to approximately 3% and was maintained at approximately 2% for up to 90 days. There was an almost immediate uptake of radioactivity by the spleen and liver which reached approximately 85% of the injected dose by 48 h. The localization of radioactivity stabilized by 48 h and thereafter the whole-body content fell by approximately 0.8% per day. Up to 5% of the administered radioactivity accumulated in the bone marrow. The activities administered were too low to produce a therapeutic response and no toxicity was experienced by the patients. A therapeutic study at higher activities is now underway.

Topics: Humans; Hydroxyquinolines; Indium Radioisotopes; Lymphocytes; Lymphoma, Non-Hodgkin; Organometallic Compounds; Oxyquinoline

Topics: Adult; Aged; Aged, 80 and over; Aortic Aneurysm; Blood Platelets; Evaluation Studies as Topic; Female; Heart Diseases; Humans; Hydroxyquinolines; Indium Radioisotopes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Thrombosis

Fifty-nine males who had gallium-67-citrate or indium-111-oxine WBC scintigraphy (Ga/In) had the images reviewed to determine if increased activity was present in the femoral vessels and, if so, whether this was age related. The 59 subjects showed an age-associated increasing bilateral uptake (13% of 15 patients younger than 40 years, to 71% of the 7 who were older than 69 years). The combined unilateral and bilateral femoral uptake rose from 27% in those under age 40, to 86% in those over age 69. The group of 59 males included 30 (51%) who had bone scintigraphy with 99mTc-MDP within 3 months of the Ga/In examination. These men showed the expected increase in femoral vessel 99mTc-MDP uptake with age. Femoral vessel activity was more commonly observed with 99mTc-MDP than with Ga/In. Thus both Ga/In and 99mTc-MDP accumulate more frequently in the femoral vessels with advancing age. Ga/In displays this age-related phenomenon to a lesser extent than 99mTc-MDP.

Topics: Adult; Aged; Aging; Citrates; Citric Acid; Femur; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Topics: Adhesiveness; Dental Materials; Equipment Contamination; Hydroxyquinolines; Indium Radioisotopes; Materials Testing; Organometallic Compounds; Oxyquinoline; Streptococcus mutans; Surface Properties

The lipophilic complex 111In-oxine was converted back to 111InCl3 by acid hydrolysis with 0.1 N HCl. Greater than 99% of the starting material was converted to 111InCl3 with a purity of 99.6%. Unlabeled oxine was completely removed by chloroform extraction. Current experimental data suggest that 111In-oxine is unstable in weak acidic medium.

Topics: Hydrochloric Acid; Hydrolysis; Hydroxyquinolines; Indium; Organometallic Compounds; Oxyquinoline; Radioisotopes

The uptake of indium-111 labelled neutrophils was examined in 30 patients with acute myocardial infarction by planar imaging and single photon emission computed tomography. The time from venepuncture to reinjection of the autologous labelled neutrophils was less than 2.5 hours and imaging was carried out 24 hours later. Twenty three patients had a positive uptake of neutrophils in the myocardium and imaging was improved by single photon emission computed tomography. There was a significant difference between the intervals from the onset of chest pain to injection of labelled neutrophils between patients with positive and negative images; early reinjection was more likely to produce a positive image. Indeed, all nine patients reinjected within 18 hours of the onset of symptoms had positive images. The results suggest that the stimulus for activation and migration of neutrophils is transient; this is an important factor if neutrophil release products play a role in cell damage after coronary occlusion.

Topics: Acute Disease; Acute-Phase Reaction; Female; Heart; Humans; Hydroxyquinolines; Indium; Inflammation; Liver; Male; Middle Aged; Myocardial Infarction; Neutrophils; Organometallic Compounds; Oxyquinoline; Radioisotopes; Spleen; Tomography, Emission-Computed

Twenty patients were studied prospectively with indium-labeled leukocyte imaging to evaluate its effectiveness in differentiating noninfected delayed or nonunion from osteomyelitis complicating these entities. All patients underwent an open surgical procedure within 24 h of the scan. Bone specimens from the nonunion site were obtained for microbiological and histological analysis to confirm the presence or absence of osteomyelitis. In these twenty patients, the sensitivity of the indium scintigraphy was 100%, the specificity 100%, and the overall accuracy 100%. Indium-labeled leukocyte scintigraphy is significantly more accurate than 99mtechnetium and 67gallium imaging had been, when studied earlier, in detecting subclinical osteomyelitis complicating nonunion. Indium-labeled leukocyte scintigraphy should supplant sequential technetium and gallium studies in this patient population when the surgeon must determine whether subclinical osteomyelitis is complicating fracture management of delayed and nonunions.

Topics: Adult; Female; Fractures, Ununited; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Prospective Studies; Radionuclide Imaging; Time Factors

Fifteen children underwent scintigraphy with indium 111 (111In)-labeled white blood cells (WBC) for the detection of a local suppuration. The procedure generally contributed to a correct diagnosis. False negative results were observed in 5 children, but in two of them positive foci were also present. The missed lesions were 2 liver abscesses, 1 lung abscess, foci of osteomyelitis and 1 pericarditis. Two cases of chronic granulomatous disease are presented in which increased leucocyte accumulation was not observed in proven instances of infection.

Topics: Adolescent; Bacterial Infections; Child; False Negative Reactions; Focal Infection; Granulomatous Disease, Chronic; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Topics: Blood Platelets; Fibrinolytic Agents; Humans; Hydroxyquinolines; Indium Radioisotopes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Thrombosis; Tropolone

Indium-111 leukocyte scanning has evolved into a practical and highly accurate method for the identification of infectious and inflammatory processes. The most commonly used agent for labeling leukocytes has been [111In]oxine. We have investigated a newer agent, 2-mercaptopyridine-N-oxide (Merc) at our institution which unlike oxine, allows us to label leukocytes in plasma, using a simple kit procedure. Of the 92 consecutive patients referred for detection or localization of an infectious process, autologous leukocytes of 55 patients were labeled with [111In]Merc, while those of the remaining 37 patients were labeled with [111In]oxine. The sensitivities for Merc and oxine procedures were 87% and 92%, respectively, while the respective specificities were 100% and 92%. We conclude that the [111In]Merc-labeled leukocytes are equally effective as [111In]oxine-labeled leukocytes in detecting infectious processes. The use of [111In]Merc is advantageous over [111In]oxine for white blood cell labeling because of its easier preparation.

Topics: Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pyridines; Radioisotopes; Radionuclide Imaging; Statistics as Topic; Thiones

Although photon deficient defects on bone scan have received a great deal of interest, such defects in bones on Indium-111 (111In) leukocyte imaging have not been as well recognized. We therefore undertook a retrospective review to determine the frequency and significance of such "cold" defects on 111In-labeled leukocyte imaging. Three hundred thirty-two scans on 290 patients were reviewed and 40 cases of decreased activity involving bone were found, for an incidence of 12%. The causes of the defects were: fracture (eight), nontraumatic avascular necrosis (eight), solid tumor (six), prostheses and other orthopedic hardware (four), advanced age (four), radiation (three), leukemia (two), osteomyelitis (two), myelofibrosis (one), postlaminectomy (one), and idiopathic (one). To determine the frequency of cold defects in osteomyelitis, all 15 cases of osteomyelitis in this series were reviewed and 12 showed increased activity, two were cold, and one was normoactive. Thus, 14% of cases of osteomyelitis presented as cold defects. We conclude that cold bone defects do occur on 111In-labeled leukocyte scans and that the causes of such defects are similar to those reported for bone and bone marrow scanning.

Topics: Bone and Bones; Bone Diseases; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Radionuclide Imaging; Retrospective Studies

Topics: Humans; Hydroxyquinolines; Indium Radioisotopes; Lymphatic System; Lymphocytes; Organometallic Compounds; Oxyquinoline; Stomach

111In-labeled leukocyte imaging has shown greater accuracy and specificity than alternative noninvasive methods in the detection of uncomplicated osteomyelitis. Forty patients with suspected osteomyelitis complicating fractures (with and without surgical intervention) were evaluated with 111In-labeled leukocytes. All five patients with intense focal uptake, but only one of 13 with no uptake, had active osteomyelitis. However, mild to moderate 111In leukocyte uptake, observed in 22 cases, indicated the presence of osteomyelitis in only four of these; the other false-positive results were observed in noninfected callus formation, heterotopic bone formation, myositis ossificans, and sickle-cell disease. These results suggest that 111In-labeled leukocyte imaging is useful for the evaluation of suspected osteomyelitis complicating fracture but must be used in conjunction with clinical and radiographic correlation to avoid false-positive results.

Topics: Adult; False Positive Reactions; Follow-Up Studies; Fractures, Bone; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Radionuclide Imaging; Retrospective Studies

When indium-111 oxine labeled neutral liposomes were incubated with Chinese hamster V79 cells in the presence of 100 mM calcium, the cell-associated radioactivity increased approximately 75-fold over that observed in the absence of calcium. This is considerably higher (approximately 20 times) than the cellular uptake obtained when these cells are incubated in the presence of 111In-oxine alone. The highest uptake of radioactivity occurred when no bovine serum albumin was present in the medium, while as little as 0.001% of the protein greatly reduced the cell-liposome association. These efficient cell labeling conditions were not found to affect the survival of the cells.

Topics: Animals; Calcium; Cell Line; Hydroxyquinolines; Indium Radioisotopes; Isotope Labeling; Liposomes; Organometallic Compounds; Oxyquinoline; Serum Albumin, Bovine

A right atrial thrombus is not often seen and only a few reports of visualization have been described. We report a 44-yr-old man who had a large atrial thrombus associated with constrictive pericarditis. Two-dimensional echocardiography and computed tomography showed a large right atrial mass. Indium-111 oxine platelet deposition was demonstrated on the surface of thrombus by platelet imaging. Platelet imaging was useful for differential diagnosis from cardiac tumor, and as an indication for surgical treatment, since right atrial thrombus may have a high risk of pulmonary embolism or severe right heart failure.

Topics: Adult; Blood Platelets; Heart Diseases; Humans; Hydroxyquinolines; Indium Radioisotopes; Male; Organometallic Compounds; Oxyquinoline; Pericarditis, Constrictive; Radionuclide Imaging; Thrombosis

Topics: Humans; Hydroxyquinolines; Indium Radioisotopes; Isotope Labeling; Lymphocytes; Organometallic Compounds; Oxyquinoline

Indium-111-labeled leukocyte scans were performed on 39 patients with suspected musculoskeletal infections to assess the usefulness of this study in detecting bone and joint infections. Results of these scans, as well as results of technetium-99m bone scans, were correlated with the patients' final diagnoses. The indium scan had an overall sensitivity of 77%, a specificity of 69%, and an accuracy of 72%. In 10 patients with a duration of symptoms of six weeks or less, the sensitivity was 100% and the specificity was 75%. In 29 patients with symptoms of greater than six weeks, the sensitivity and specificity were lower at 50% and 71% respectively. Technetium-99m bone scans were performed on 23 patients; sensitivity for infection was 100% while specificity was 60%. Our results suggest that the indium-111 leukocyte scan is a useful adjunct in the diagnosis of acute musculoskeletal infections, but may be inconclusive in chronic infections.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Diseases; Child; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Infections; Leukocytes; Male; Middle Aged; Muscular Diseases; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Topics: Humans; Hydroxyquinolines; Indium Radioisotopes; Organometallic Compounds; Oxyquinoline; Pseudomonas aeruginosa; Staphylococcus aureus

Topics: Blood Platelets; Embolism; Extremities; Follow-Up Studies; Humans; Hydroxyquinolines; Indium Radioisotopes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Using a method of 111In-oxine granulocyte labelling in diluted plasma, we performed 162 scintigraphic studies in 159 patients with suspected non-osseous infection. We obtained a positive predictive value of 82%, and a negative predictive value of 97%, i.e. the method is very sensitive, albeit less specific. Sequential imaging showed around 50% of the scintigrams to turn positive at 30 min after the injection, the most rapid accumulation being seen in cases of superficial soft tissue infections and in pulmonary and pleural infections, cerebral abscesses showing a rather sluggish accretion of activity, urinary tract infections, abdominal abscesses and bowel inflammation accumulating activity at an intermediate rate. Our results indicate that the described method is sensitive, and that the sequential scintigraphic approach allows an early diagnosis in most cases, and facilitates the interpretation of delayed scans.

Topics: Focal Infection; Granulocytes; Humans; Hydroxyquinolines; Indium Radioisotopes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Time Factors

99mTc-hexamethylpropylene amine oxime d,l diastereoisomer (HM-PAO), developed as a diffusible brain imaging agent, labels leukocyte suspensions in saline with an efficiency of 80% using 1-200 micrograms quantities. In dogs, the recovery and survival of reinjected cells in the bloodstream resemble those of 111In-oxine labeled cells at least for several hours. Images in control animals at 18 h show the spleen, liver, marrow, and bladder, minimal pulmonary activity and some gastrointestinal activity. Induced E. coli abscesses and joint inflammatory lesions in dogs are shown on 18 h images. This complex appears promising as an agent for abscess detection in humans. However, strict quality control of this agent is necessary, and it must be used immediately after the 99mTc complex is formed for labeling cells.

Topics: Abscess; Animals; Dogs; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Organometallic Compounds; Oximes; Oxyquinoline; Radionuclide Imaging; Technetium Tc 99m Exametazime; Tissue Distribution

Scintigraphy with indium-labeled white blood cells has been reported to be sensitive and specific in the diagnosis of low-grade sepsis of the musculoskeletal system. We reviewed the records of fifty patients who had suspected osteomyelitis or suspected infection about a total joint prosthesis and who underwent scintigraphy with technetium-99m methylene diphosphonate and scintigraphy with indium-111 oxine-labeled white blood cells before an open surgical procedure. Any patient who received preoperative antibiotics was not included in the study. For all of the patients, gram-stain examination of smears, evaluation of a culture of material from the operative site, and histological examination were done. The patients were divided into two groups. Group I was composed of twenty-four patients, each of whom had a prosthesis in place and complained of pain. Group II was composed of twenty-six patients for whom a diagnosis of chronic osteomyelitis had to be considered. With the indium scans alone, there was only one false-negative result (in Group II), but there were eighteen false-positive results (eight patients in Group II and ten patients in Group I). Although scintigraphy with indium-labeled white blood cells is quite sensitive, it is not specific in detecting chronic osteomyelitis; a negative scan should be considered highly suggestive that osteomyelitis is not present. Specificity can be increased by interpreting the indium scan in conjunction with the technetium scan.

Topics: Adult; Aged; Bacterial Infections; False Negative Reactions; False Positive Reactions; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Preoperative Care; Radionuclide Imaging; Technetium Tc 99m Medronate

To utilize 111In leukocytes in a routine work, simplified procedure for sterile leukocytes preparation and labeling with water soluble oxine sulfate was performed. Viability and chemotaxis of leukocytes were maintained during separation and labeling. Chelated rate of 111In with oxine sulfate was 93.5%. Labeling efficiency of 111In leukocytes was 93.8%. Obvious blood pool images due to remained erythrocytes were not observed. 111In labeled leukocytes showed good migration into inflammatory focci.

Topics: Humans; Hydroxyquinolines; Indium Radioisotopes; Isotope Labeling; Leukapheresis; Leukocytes; Liver Abscess; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

This study describes the effects of the beta 2 receptor agonist terbutaline on platelet sequestration in sheep exposed to endotoxin shock. The in vivo behavior of Indium-111-labeled platelets was followed simultaneously in the lungs, liver, spleen, and kidneys. The effects on the respiratory function and the central hemodynamics were also followed. Twelve adult sheep were given endotoxin (10 micrograms/kg bw), and six of those received a continuous intravenous infusion of terbutaline (20 micrograms/kg/hr) during 4 hr, starting 30 min after injection of endotoxin. The other six acted as controls. It was found that a marked pulmonary and hepatic platelet sequestration occurred during and just after the endotoxin infusion and was followed by a marked platelet disaggregation within 30 min in both groups. Three hours after the endotoxin a second wave of platelet trapping occurred in the control animals in both the lungs and the liver, while no such increase was seen in the terbutaline-treated animals. In the spleen, however, there was a decrease in platelet sequestration after endotoxin in both groups, and in the kidneys only minor changes occurred. Furthermore, less marked hemodynamic and respiratory alterations occurred in the terbutaline group compared with the controls. It was concluded that terbutaline decreased sequestration of platelets in the lungs and in the liver of sheep in endotoxin shock, which may be of importance in the development of multiple organ failure.

Topics: Animals; Blood Platelets; Hydroxyquinolines; Indium Radioisotopes; Liver; Lung; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Sheep; Shock, Septic; Terbutaline

A method for labeling leukemic cells in vitro with 111In-oxine is described. Intravascular survival data and organ distribution of 111In-oxine-labeled leukemic cells in patients with acute leukemia are presented. No evidence of diminished cell viability or significant elution of the label could be found by the in vitro studies. Disappearance curves of 111In-labeled leukemic cell radioactivity in the circulation were a single exponential with average T1/2 value of 15.3 +/- 2.5 hr (mean +/- SEM), which was found to be prolonged when compared with the results of 4 hematologically normal subjects (7.0 +/- 0.8) and those of previously reported DF32P studies. Migratory patterns of the labeled leukemic cells, obtained by a scintillation camera, demonstrated sequestration in the lungs 5 min after the infusion, and thereafter, the uptake into the spleen and liver gradually increased. We believe that the properties of 111In-oxine might overcome many of the difficulties of studying leukemic cell kinetics with cells labeled with tritiated thymidine.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Cell Survival; Female; Humans; Hydroxyquinolines; In Vitro Techniques; Isotope Labeling; Leukemia; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Tumor Cells, Cultured

17 patients with known small bowel involvement in Crohn's disease (clinically active, n = 14; clinically inactive, n = 3) were examined within 8 days via barium enemas of the small bowel (Pansdorf's method or enteroclysis) and by 111In-oxine labelled leucocytes. From 19 radiologically diagnosed small bowel stenoses 14 were classified as inflammatory and 5 as non-inflammatory. The leucocyte scan also showed 14 inflammatory stenoses. The not inflamed stenoses could not be diagnosed scintigraphically. The barium enemas of the small bowel and the leukocyte scans both correctly diagnosed the acute inflamed segments. The inability to show non-inflamed segments (n = 5) and to localise small bowel stenoses exactly is disadvantageous in the scan. The advantage of the leucocyte scan is a non-invasive examination without specific bowel preparation and the possibility to diagnose additionally inflamed large bowel segments (n = 4), fistulas and abscesses (n = 2). The leucocyte scan offers a useful expansion of the diagnostic tools in small bowel diseases, especially in radiological problems in patients with Crohn's disease.

Topics: Adult; Aged; Crohn Disease; Female; Humans; Hydroxyquinolines; Indium; Intestinal Obstruction; Intestine, Small; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

The lack of a rapid, noninvasive, and accurate method to confirm or rule out prosthetic graft infection continues to constitute a compelling and vexing clinical problem. A host of adjunctive diagnostic techniques has been used in the past, but early promising results subsequently have usually not yielded acceptable sensitivity (reflecting false negatives) and specificity (reflecting false positive) data. White blood cell (WBC) indium 111 scanning has recently been added to this list. The utility and accuracy of 111In WBC scans were assessed by retrospective review of WBC scan results in 70 patients undergoing evaluation for possible prosthetic graft infection over a 7-year period. Operative and autopsy data (mean follow-up, 18 months for survivors with negative scans) were used to confirm the 22 positive, 45 negative, and three equivocal WBC scans. The false positive rate (+/- 70% confidence limits) was 36% +/- 6% (n = 8) among the 22 patients with positive scans (44% +/- 6% [11 of 25] if the three equivocal scans are included as false positive), yielding a specificity of 85% +/- 5% and an overall accuracy rate of 88% +/- 4% (80% +/- 5% and 84% +/- 5%, respectively, if the three equivocal cases are considered as false positive). All three patients with equivocal scans ultimately were judged not to have prosthetic graft infection. As implied by the high accuracy rate, the sensitivity of the test was absolute (100% [14 of 14]); there were no false negative results. (ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Blood Vessel Prosthesis; False Negative Reactions; False Positive Reactions; Female; Follow-Up Studies; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Surgical Wound Infection; Time Factors

Since the differential diagnosis between cyclosporine (CyA) nephrotoxicity and acute graft rejection is still a problem in clinical routine, we studied retrospectively the value of 111-indium (In) platelet scintigraphy in 53 patients immunosuppressed with CyA and prednisolone. Autologous platelets were labeled once per week. After daily gamma camera imaging, the platelet deposition in the graft was expressed as platelet-uptake ratio (PUR). The patients were monitored during the first 4-6 weeks after surgery. PUR values measured during an episode of graft dysfunction were compared to the histological diagnosis. The PUR of well-functioning and stable grafts measured 1.07 +/- 0.11 (mean +/- SD). The 111-In platelet scintigraphy failed to register acute interstitial rejection. The PUR values in episodes of chronic vascular rejection, of acute tubular necrosis due to prolonged ischemia times, of tubular CyA nephrotoxicity and of cytomegalovirus (CMV) infection did not differ from the PUR of well-functioning and stable grafts as well. The PUR was significantly increased to 1.48 +/- 0.26 because of a marked platelet deposition in the graft in episodes of acute vascular rejection. In 4 cases of microvascular CyA nephrotoxicity the same phenomenon of significantly increased PUR (1.33 +/- 0.18), could be encountered, too. Two of these 4 cases resembled the hemolytic uremic syndrome (HUS). The value of PUR measurement for diagnosis of acute vascular rejection and microvascular CyA nephrotoxicity together, was: sensitivity 0.62, specificity 0.95, predictive value of positive result 0.64, predictive value of negative result 0.94.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Biopsy; Blood Platelets; Cyclosporins; Diagnosis, Differential; Female; Graft Rejection; Humans; Hydroxyquinolines; Indium; Kidney; Kidney Transplantation; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Prednisolone; Radioisotopes; Radionuclide Imaging; Retrospective Studies

In-111 oxine WBC abdominal scanning is now a widely accepted technique for the detection of abdominal infectious processes. High sensitivity and specificity are achieved. In-111 labeled leukocyte accumulation, however, does not always suggest the diagnosis of abscess. Higher specificity could be obtained by the knowledge of the In-111 leukocyte distribution pattern in the abdomen in other pathologic states like inflammation of abdominal wounds, stoma; surgical complication without abscess formation; inflammatory or ischemic bowel disease; or swallowing leukocytes which subsequently are visualized in the intestinal lumen. One hundred fifty-two consecutive WBC scans performed over 18 months were reviewed and classified according to their pattern of uptake: 96 cases showed no abdominal uptake, and 56 had accumulation of leukocytes in the abdomen. Twenty-eight of these patients had proven abdominal abscess, and the remaining 26 were positive due to other causes. This report briefly discusses the distribution pattern of In-111 labeled leukocytes in the latter patients and compares the results obtained using different diagnostic criteria.

Topics: Abdomen; Abscess; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Topics: Aged; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Sepsis; Staphylococcal Infections; Thrombophlebitis

The usefulness of scintigraphy with 111In-oxine-labelled autologous leucocytes was investigated in 27 patients with inflammatory bowel disease (IBD): 16 with ulcerative colitis and 11 with Crohn's disease. Scans were performed 2-4 h (early scan) and at 24 h (late scan) after leucocyte reinjection. No false-negative results occurred in the early scan; however, in the late scan, 2 patients with Crohn's disease had a normal scintigram. A new index of activity (Il) based on the number and relative activity of abnormal 111In-leucocyte zones was used for scan quantitation. All patients with clinically active IBD had Il greater than or equal to 2. The scintigraphic index showed a significant correlation with the Harvey clinical index, especially in patients with ulcerative colitis. Our results suggest that an early scan (2-4 h) provides useful information in cases of IBD, and that Il greater than or equal to 2 is indicative of the degree of disease activity in such patients.

Topics: Adolescent; Adult; Colitis, Ulcerative; Crohn Disease; False Negative Reactions; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

The in vitro use of the radioisotope indium 111 (111In) was examined as a radiolabel for lymphocytes obtained from both normal individuals and patients with a variety of lymphoid malignancies. Successful cell labeling requires a chelator. The traditional agent oxine, has proved to be toxic to the lymphoid lineage. Cellular uptake of 111In mediated by the chelator oxine was compared with that of a new chelator, tropolone. Oxine provided better labeling efficiency (48%) than tropolone (35%) for the labeling of normal lymphocytes. By contrast, lymphocytes from patients with chronic lymphocytic leukemia had a nearly twofold greater labeling efficiency when tropolone was substituted for oxine. Further studies demonstrated that tropolone induced functional injury to lymphocytes when mitogenic response to concanavalin A, pokeweed mitogen, and phytohemagglutinin was assessed. Similar toxicity was found when tropolone was compared with oxine. In addition, tropolone produced damaging structural changes seen by both scanning and transmission electron microscopic examination. These changes were both variable and not predictable. Shortening of the incubation time of the chelator with the cell provided the least amount of cellular injury. These findings suggest that tropolone be used as an alternative mediator of lymphocyte labeling with 111In only under critically defined conditions.

Topics: Cells, Cultured; Cycloheptanes; Hodgkin Disease; Humans; Hydroxyquinolines; Indium; Leukemia; Leukemia, Lymphoid; Lymphocyte Activation; Lymphocytes; Lymphoma; Microscopy, Electron; Microscopy, Electron, Scanning; Organometallic Compounds; Oxyquinoline; Tropolone

The use of In-111 labeled leukocytes for abscess localization is becoming well established. The first report of In-111 imaging following hepatic embolization is presented. A 45-year-old man with adenocarcinoma of the colon and metastatic liver disease was treated for intractable pain using particulate embolization of the hepatic artery. In-111 leukocyte imaging was performed to rule out abscess formation. The distribution of the labeled leukocytes demonstrated hepatic uptake commensurate with Tc-99m sulfur colloid (SC) images. Areas of embolization did not accumulate tracer. Pathologic examination at autopsy correlated with the distribution of the labeled leukocytes. Thus, therapeutic embolization did not alter the normal distribution of this tracer in functional hepatic tissue.

Topics: Adenocarcinoma; Colonic Neoplasms; Embolization, Therapeutic; Hepatic Artery; Humans; Hydroxyquinolines; Indium; Leukocytes; Liver Abscess; Liver Neoplasms; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pain, Intractable; Radioisotopes; Radionuclide Imaging

Topics: Adult; Blood Platelets; Evaluation Studies as Topic; Female; Heart Diseases; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Thrombosis; Tomography, Emission-Computed

Topics: Bone Neoplasms; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Lung Neoplasms; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Topics: Adolescent; Child; Child, Preschool; Humans; Hydroxyquinolines; Indium; Infant; Infant, Newborn; Leukocytes; Organometallic Compounds; Oxyquinoline; Radiation Dosage

One hundred sixty-two white-blood-cell scans were retrospectively reviewed to determine the sensitivity and specificity of the test for pulmonary and pleural infection. All scans were performed 18-24 hr after injection of indium-111 oxine-labeled autologous or donor cells. Pulmonary activity was graded on a scale of 0-4: 0 = equal to soft tissue; 1 = greater than soft tissue but less than rib; 2 = equal or greater than rib but less than liver; 3 = equal or greater than liver but less than spleen; 4 = equal to spleen. Activity was also characterized as being focal or diffuse. The white-blood-cell scan findings were correlated with the clinical diagnosis on the basis of physical examination, laboratory results, chest radiographs, clinical course, and pathologic studies when available. As pulmonary activity increased from grade 1 to 4, sensitivity declined from 93% to 14% and specificity increased from 64% to 100%. The sensitivity and specificity of focal uptake were 31% and 89% vs 62% and 74% for diffuse pulmonary activity. Making a distinction between focal and diffuse activity did not improve the specificity of low grades of pulmonary activity. The white-blood-cell scan can be very sensitive or very specific for pulmonary or pleural infection, depending on the criteria selected for a positive scan.

Topics: Adolescent; Adult; Aged; Empyema; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Lung; Lung Diseases; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pleural Diseases; Pneumonia; Radionuclide Imaging; Respiratory Tract Infections

Topics: Abdomen; Abscess; Bone Diseases; Enterocolitis; Humans; Hydroxyquinolines; Indium; Neutrophils; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

A false-negative In-111 WBC scan was obtained in a case of a large, infected hemophiliac pseudotumor. Following aspiration of the abscess, a positive scan was seen, demonstrating that In-111 WBC imaging occasionally may be misleading as a diagnostic tool.

Topics: Adult; False Negative Reactions; Fibroma; Hemophilia A; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Retroperitoneal Neoplasms; Salmonella Infections

Topics: Aged; Female; Humans; Hydroxyquinolines; Indium; Kinetics; Leukemia, Lymphoid; Lymphocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline

The liver was not visualized by In-111 WBC scan in a patient with alcoholic liver disease. The liver was visualized on repeat scan when liver function had improved.

Topics: Adult; Humans; Hydroxyquinolines; Indium; Leukocytes; Liver; Liver Diseases, Alcoholic; Male; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

The effect of labeling media on the kinetics of[111In]platelets was evaluated by performing a paired crossover study in eight normal human subjects using tropolone and oxine methods. Platelets were labeled in autologous plasma with [111In]tropolone (In-tr) and in ACD-saline with [111In]oxine (In-ox) and reinjected. Starting at 1 hr, ten blood samples were obtained over an 8-day period. The in vivo platelet recovery was higher at 1 hr and throughout the 8 days of study with In-tr and the gamma camera images showed less uptake in liver and spleen than with In-ox. When platelet life-span (PLS) was estimated using all ten samples, only linear regression showed that the platelet life-span was longer with In-tr (10.7 +/- 1.5) than with In-ox (9.5 +/- 0.8). When the PLS was estimated excluding the 1-hr sample point, the life-span of platelets was significantly longer with In-tr than with In-ox based on three out of four models of curve fitting. These results demonstrate that platelets labeled with In-tr in plasma are preserved better in circulation and have equal or longer life-span than platelets labeled with In-ox in ACD-saline.

Topics: Adult; Blood Platelets; Cell Survival; Cycloheptanes; Female; Humans; Hydroxyquinolines; Indium; Male; Organometallic Compounds; Oxyquinoline; Radioisotopes; Time Factors; Tropolone

Topics: Colitis; Female; Humans; Hydroxyquinolines; Indium; Middle Aged; Neutrophils; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Indium-111 leukocyte scanning is a reliable means of locating acute infection in adults, but its use in the pediatric population has not been extensively documented. The results of scans on 30 children retrospectively reviewed are presented. Acute infections were detected in 15 of 16 patients (94% sensitivity) with one false negative scan. There were 8 truly negative and 6 falsely positive studies (57% specificity).

Topics: Adolescent; Child; Child, Preschool; Fever of Unknown Origin; Humans; Hydroxyquinolines; Indium; Infant; Infections; Leukocytes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

We describe a simple and reliable technique for labeling Pseudomonas aeruginosa with a readily available commercial preparation of indium-111 (111In) oxine. Labeling of a heavy bacterial suspension with 500 mu Ci of commercially prepared 111In-oxine resulted in a yield of 0.0004 mu Ci of cell-associated 111In per 10(6) colony-forming units (CFU). The label was 88% bacterially associated and did not effect viability of the organism. Radiolabeling a gram-negative organism with 111In-oxine provides a non-toxic, stable gamma-emitting bacterial tracer.

Topics: Animals; Blood; Culture Media; Dogs; Hydroxyquinolines; Indium; Organometallic Compounds; Oxyquinoline; Pseudomonas aeruginosa; Radioisotopes; Stem Cells; Time Factors

Indium-labelling of red cells is hampered by its high elution rate and short physical half-life. From a study of 23 pathological cases, it is demonstrated that the simultaneous study of 111In- and 51Cr-labelled red cells could only be useful in haemolytic anaemias in which the mechanisms (corpuscular or extra-corpuscular) of the cell destruction is in question.

Topics: Anemia, Hemolytic; Chromium Radioisotopes; Erythrocyte Aging; Erythrocytes; Half-Life; Humans; Hydroxyquinolines; Indium; Kinetics; Male; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

Twenty five In-111 oxine platelet imaging procedures were performed in 21 renal transplant patients to assess the value of this study for diagnosis of renal transplant rejection in recipients receiving cyclosporine (CYS) for immunosuppression. Fourteen biopsies were performed, and an extensive, in-depth review of the clinical progress of each patient was obtained. There was no ideal "gold standard" to which our imaging results could be compared, but we used a combination of biopsy findings, clinical impressions, and changes in renal function after pulsing with steroids and/or decreasing CYS dosage as the basis for our diagnoses. We were unable to distinguish between renal rejection and CYS toxicity using platelet imaging. The sensitivity of the platelet procedure for diagnosing rejection or CYS toxicity was 100%. The specificity for rejection or CYS toxicity was only 76.5%. In view of the inability of this test to distinguish between rejection and CYS toxicity, its rather low specificity, and its relatively high cost, it is not a particularly helpful study for the diagnosis of renal transplant rejection in patients on CYS.

Topics: Blood Platelets; Cyclosporins; Graft Rejection; Humans; Hydroxyquinolines; Indium Radioisotopes; Kidney; Kidney Transplantation; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

A case of artifactual multifocal lung activity presumably due to emboli of In-111 labeled leukocytes is described. These may have been caused by infusion through an intravenous line containing glucose, or by a minute amount of blood clotted in the needle. When administration through an existing intravenous line is necessary, flushing with saline before and after cell infusion is recommended to avoid this potential pitfall. A fresh needle also should be used for each venipuncture attempt.

Topics: Abscess; Aged; Aged, 80 and over; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Kidney Diseases; Leukocytes; Lung; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Factors that might affect the biodistribution and clinical utility of radiolabeled lymphocytes were evaluated in experimental animals. Indium-111 (In-111) labeled lymphocytes (10(7)-10(9) syngeneic or allogeneic cells; 1-10 microCi [.037-.37 MBq]/10(8) cells) obtained from peripheral blood, lymph node, or spleen were found in significant amounts in the lymphoid tissues of Lewis rats as early as 3 hours after infusion. A progressive increase in nodal activity with concomitant fall of activity in other organs followed, indicating active recirculation of the lymphocytes. However, In-111 labeled thymocytes or xenogeneic lymphocytes failed to accumulate in lymphoid tissue. In vitro irradiation of the In-111 labeled lymphocytes (100-400 rads [1-4 Gy]) before in vivo administration and increase of the In-111 to 40 microCi [1.48 MBq]/10(8) lymphocytes resulted in no detectable lymphocyte recirculation and/or reduced localization in lymphoid tissue. Splenectomized animals and those sensitized to an organ allograft before cell infusion showed increased activity in their bone marrow. These results suggest that the source of the injected cells, cell irradiation dose level, and host sensitization should be considered when radiolabeled lymphocytes are being prepared for use in clinical diagnosis and therapy.

Topics: Animals; Epitopes; Gamma Rays; Graft Rejection; Heart Transplantation; Hydroxyquinolines; Immunization; Indium; Lymph Nodes; Lymphocyte Transfusion; Lymphocytes; Organometallic Compounds; Oxyquinoline; Rabbits; Rats; Rats, Inbred F344; Rats, Inbred Lew; Splenectomy; Transplantation, Isogeneic

111In-oxine "pure" granulocyte scanning allows an exact localisation of infiltrated bowel in Crohn's disease and ulcerative colitis. Fecal excretion of labeled granulocytes yields a good parameter of disease activity. In comparison to 111In-oxine "mixed" leukocyte scanning, this method is more specific in assessing disease activity and more sensitive in localising diseased bowel. Radiation exposure to blood cells is not as high as in "mixed" leukocyte scanning. Pure granulocytes were isolated by discontinuous density gradient centrifugation of an isolated "mixed" leukocyte fraction.

Topics: Adult; Colitis, Ulcerative; Crohn Disease; Female; Granulocytes; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

A 54-year-old man was admitted to hospital with a 3-month history of progressive dyspnea with coughing. A giant right atrial mass, originating from a hepatocellular carcinoma, was visualized by computed tomography, and digital subtraction angiography. The volume of the right atrial mass was increasing rapidly. It was therefore essential to determine whether this giant mass was a tumor thrombus or a multiplication of the hepatocellular carcinoma. 111In-oxine labeled platelet scintigraphy revealed active accumulation in the right atrium caused by the presence of active platelet deposition, and slight accumulation in the lung fields probably due to embolic showers originating from the tumor thrombus in the right atrium. This is the first case report showing that 111In-oxine labeled platelet scintigraphy can aid in confirming the nature of a giant tumor thrombus in the right atrium and can clarify the pathogenesis of the respiratory symptoms.

Topics: Blood Platelets; Carcinoma, Hepatocellular; Coronary Disease; Heart Atria; Heart Neoplasms; Humans; Hydroxyquinolines; Indium; Liver Neoplasms; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Recent animal and human studies have suggested that positive indium 111-labeled leukocyte scans may help establish the diagnosis of vascular graft infection; however, there is little information available about the predictive value of both positive and negative leukocyte scans in larger groups of patients. In this study 31 indium 111 leukocyte scans were performed prior to definitive treatment in 21 patients with suspected vascular graft infections. Patients with more than one leukocyte scan performed had either anatomically distinct sites of infection or rescanning of a potentially infected site after definitive treatment. Scans were performed according to the method of Baker et al., attaching 500 muCi of indium 111 to leukocytes with imaging 24 hours later. All patients with positive scans underwent surgical exploration of the area of leukocyte accumulation, with documentation of purulence and culture of the graft. Patients with negative scans were treated as if scan results were indeterminate and underwent surgical exploration for usual clinical indications; if no exploration was performed, the patient was followed up closely for at least 1 year. Twelve of 12 positive scans showed purulence or culture evidence of infection with three different organisms; in 15 instances of negative scans, two operations were performed with one infection noted, whereas no patient without surgery has had a graft infection at 10 months follow-up. In addition to localizing graft infections, two scans demonstrated a nonvascular site of infection. Positive scans also helped determine the extent of infection along the graft, allowing better planning of the surgical procedure. These results indicate that indium 111-labeled leukocyte scans help document and localize prosthetic vascular graft infections.

Topics: Aged; Bacterial Infections; Blood Vessel Prosthesis; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Polyethylene Terephthalates; Polytetrafluoroethylene; Radioisotopes; Radionuclide Imaging; Reoperation; Surgical Wound Infection

The purpose of this study was to compare the effect of indium oxine and indium-tropolone complexes (nonradiolabeled) on the function of isolated human lymphocytes. peripheral lymphocytes were obtained from 15 normal volunteers and incubated with indium oxine or indium tropolone according to the standard techniques currently used when cells are radiolabeled for subsequent in vivo studies. The phytohemagglutinin-induced (PHA) lymphocyte transformation and a more specific lymphocyte functional test (the mixed lymphocyte reaction) were performed following incubation with the indium complexes. The results indicate that PHA transformation is not affected by either indium oxine or indium tropolone, whereas both chelates reduced the mixed lymphocyte reaction. This suggests that these substances have a selective toxic effect only on a functionally distinct lymphocyte subset (i.e., the cytotoxic T cells) and indicates that there is no significant difference between the two indium chelates in terms of their effect on lymphocyte function.

Topics: Adult; Cells, Cultured; Cycloheptanes; Female; Humans; Hydroxyquinolines; Indium; Lymphocyte Activation; Lymphocyte Culture Test, Mixed; Lymphocytes; Male; Organometallic Compounds; Oxyquinoline; Phytohemagglutinins; Radioisotopes; Tropolone

The preparation is given of an 111indium-oxine complex that is non toxic and can label reproductively various types of cells. They retain the label for long periods (24 hours and more). This method gives parallel results for cell-mediated cytotoxicity measurements to Chromium-51 labelling and is found to have wider uses. It can label cells that release 51Cr too fast, makes possible long term measurements of cytotoxicity and accurate counts on small numbers of target cells.

Topics: Animals; Cell Line; Chromium Radioisotopes; Cytotoxicity Tests, Immunologic; Hydroxyquinolines; Indium; Lymphocyte Culture Test, Mixed; Mice; Mice, Inbred Strains; Organometallic Compounds; Oxyquinoline; Radioisotopes; Sarcoma; Spleen; T-Lymphocytes, Cytotoxic; Time Factors

We have studied the uptake and toxicity of [111In]oxine in Chinese hamster V79 lung fibroblasts. The incorporation of the radionuclide into these cells reached a plateau within 2 hr. Uptake was proportional to the extracellular radioactive concentration. Both radioactive and "decayed" [111In]oxine exhibited similar toxicities, indicating that the observed toxicity was chemical in nature. These results are discussed in terms of the present status of this radiolabeling agent.

Topics: Animals; Cell Line; Cell Survival; Cricetinae; Cricetulus; Hydroxyquinolines; Indium; Organometallic Compounds; Oxyquinoline; Radioisotopes

The kinetics and distribution in vivo of autologous 111-In-labelled platelets were studied in 20 patients with chronic hepatic disease. The patients, 16 of whom were thrombocytopenic, exhibited a shortened platelet mean life time, a reduced platelet recovery and a normal platelet turnover, the latter 2 of which were positively correlated to the platelet count. Platelet in vivo recovery was negatively correlated to the spleen volume. In accordance with this, scintigraphic studies revealed that the spleen was the major organ of platelet sequestration and destruction, the role of the liver being almost negligible. Signs of platelet destruction in the bone marrow were also found. Our results indicate that splenic platelet pooling and accelerated platelet destruction, accompanied by inability of the bone marrow to compensate for the thrombocytopenia are the main causes of the thrombocytopenia accompanying chronic hepatic disease.

Topics: Adult; Aged; Blood Platelets; Bone Marrow; Cell Survival; Chronic Disease; Female; Humans; Hydroxyquinolines; Indium; Kinetics; Liver; Liver Diseases; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Platelet Count; Radioisotopes; Radionuclide Imaging; Spleen; Thrombocytopenia

The kinetics of autologous 111In-labelled platelets were studied in 26 patients with ITP. The platelet mean life time (MLT) was considerably shortened, the platelet in vivo recovery slightly lowered and the platelet turnover normal. Comparative studies of the kinetics of simultaneously injected 111In- and 51Cr-labelled platelets in 10 patients showed the MLT and turnover of 51Cr-platelets to be shorter and higher, respectively, than those of 111In-platelets, suggesting that 51Cr-labelling in ITP may underestimate platelet MLT and overestimate platelet turnover. Our results confirm that accelerated platelet destruction is an important pathogenetic factor in ITP, and that the platelet concentration may be influenced by increased splenic platelet pooling and by inability of the bone marrow to respond adequately to the low platelet count. Our scintigraphic studies showed that the spleen played an important role for platelet destruction in most patients, with the liver contributing in some patients.

Topics: Adolescent; Adult; Aged; Blood Platelets; Bone Marrow; Cell Survival; Child; Female; Humans; Hydroxyquinolines; Indium; Infant; Kinetics; Liver; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Platelet Count; Purpura, Thrombocytopenic; Radioisotopes; Radionuclide Imaging; Spleen

We prospectively compared sequential technetium-gallium imaging with indium-labeled-leukocyte imaging in fifty patients with suspected low-grade musculoskeletal sepsis. Adequate images and follow-up examinations were obtained for forty-two patients. The presence or absence of low-grade sepsis was confirmed by histological and bacteriological examinations of tissue specimens taken at surgery in thirty of the forty-two patients. In these thirty patients, the sensitivity of sequential Tc-Ga imaging was 48 per cent, the specificity was 86 per cent, and the accuracy was 57 per cent, whereas the sensitivity of the indium-labeled-leukocyte technique was 83 per cent, the specificity was 86 per cent, and the accuracy was 83 per cent. When the additional twelve patients for whom surgery was deemed unnecessary were considered, the sensitivity of sequential Tc-Ga imaging was 50 per cent, the specificity was 78 per cent, and the accuracy was 62 per cent, as compared with a sensitivity of 83 per cent, a specificity of 94 per cent, and an accuracy of 88 per cent with the indium-labeled-leukocyte method. In patients with a prosthesis the indium-labeled-leukocyte image was 94 per cent accurate, compared with 75 per cent accuracy for sequential Tc-Ga imaging. Statistical analysis of these data demonstrated that the indium-labeled-leukocyte technique was superior to sequential Tc-Ga imaging in detecting areas of low-grade musculoskeletal sepsis.

Topics: Adolescent; Adult; Aged; Diphosphonates; Female; Gallium Radioisotopes; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Leukocytes; Male; Middle Aged; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Prospective Studies; Radiography; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Abdomen; Abscess; Animals; Cell Separation; Humans; Hydroxyquinolines; Indium; Lethal Dose 50; Leukocytes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Rats; Tissue Distribution; Tropolone

Topics: Abdomen; Abscess; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Postoperative Complications; Radionuclide Imaging

Sixteen patients with intracerebral mass lesions where computed tomography (CT) was not fully conclusive with respect to the differential diagnosis between brain tumor and abscess were examined with leukocyte brain scintigraphy (LBS). Autologous leukocytes were labeled with indium-111 oxinate and were reinjected intravenously; registration with a gamma camera was performed after 24 and 48 hours. In 10 of 11 patients with the final diagnosis of a brain tumor, no accumulation of radiolabeled leukocytes could be detected in the brain. In 4 of 5 patients with the final diagnosis of brain abscess, scintigraphy showed a pronounced increase of focal activity corresponding to the lesion demonstrated with CT. The reasons for the one false-positive and the one false-negative result are discussed, and it is concluded that LBS (a) can be used to detect intracranial infection and (b) may be a useful diagnostic tool for distinguishing between brain abscess and brain tumor.

Topics: Adult; Aged; Brain Abscess; Brain Neoplasms; Diagnosis, Differential; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Time Factors

A technique for monitoring pancreatic allografts in man is presented. The method utilizes 111-indium labelled autologous platelets and provides quantitative and qualitative analysis of uptake of the tracer by the graft. Five patients without any significant accumulation of radiolabelled platelets in their transplants had an uneventful recovery and left hospital with satisfactory graft function. The three patients who suffered graft failure showed abnormal uptake of the tracer. This presented as a diffuse platelet accumulation within the transplanted pancreas in the case of acute rejection, or as a focal accumulation in two cases of venous thrombosis. Minor complications such as perigraft haematoma can also be diagnosed using this technique. We suggest that 111-indium labelled platelets provide a valuable diagnostic aid in the management of pancreatic transplant recipients.

Topics: Adolescent; Adult; Blood Platelets; Female; Graft Rejection; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pancreas; Pancreas Transplantation; Postoperative Complications; Radioisotopes; Radionuclide Imaging; Thrombophlebitis

Autologous lymphocytes were labeled with In-111 oxine in 26 patients with chronic inflammatory disease. Whole body gamma camera scans were performed at 24 and 48 hours post injection. Activity was normally seen in spleen, liver, bone marrow, and cervical and inguinal lymph nodes; any activity outside there areas was considered abnormal. Five out of 11 patients with proven or suspected chronic osteomyelitis had positive scans. Four out of five patients with chronic arthritic diseases had positive scans. Also, three patients had bladder uptake suggesting bladder inflammation on a chronic basis.

Topics: Adult; Aged; Chronic Disease; Humans; Hydroxyquinolines; Indium; Inflammation; Lymphocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Time Factors; Whole-Body Counting

Optimal labelling conditions of human platelets with 111In-oxine were determined in vitro. Based on this optimized technique, platelet mean life span (MLS) and platelet sequestration site were comparatively evaluated in 79 patients with two labels, 51Cr (n = 26) and 111In (n = 53). Patients were subgrouped according to clinical criteria as autoimmune thrombocytopenic purpura (AITP) (group 1; n = 49), hypersplenism (2; n = 12), impaired thrombopoiesis (3; n = 3), unclassified thrombocytopenia (4; n = 6), and nonthrombocytopenic patients (5; n = 9). In patients with AITP and hypersplenism the mean values for the MLS determined either with 51Cr or with 111In were lowered but the difference was not statistically significant, neither for group 1 (18.6 h vs 17.3 h; P greater than 0.2) nor for group 2 (94.7 vs 122.3 h; P greater than 0.2). The correlation between MLS and platelet counts in patients with AITP was significant for both labels (P less than 0.001). The 15 min recovery tended to be higher with 111In in all groups, but the difference was significant (P less than 0.05) only for group 1. The sequestration sites were similar with both labels. We conclude that, contrary to previous reports, platelet survival studies yield similar results with both the 51Cr and 111In methods. Due to its distinct advantages 111In is the label of choice for investigation of platelet kinetics.

Topics: Blood Platelets; Cell Survival; Chromium Radioisotopes; Hematopoiesis; Humans; Hydroxyquinolines; Hypersplenism; Indium; Organometallic Compounds; Oxyquinoline; Purpura, Thrombotic Thrombocytopenic; Radioisotopes; Radionuclide Imaging; Thrombocytopenia

There is considerable disagreement as to whether oxine or tropolone is the best labeling agent for indium leukocytes. We have previously looked at the sensitivity of oxine-labeled 111In leukocyte scans for occult infections and now present a similar group of patients imaged with tropolone-labeled 111In leukocytes. Thirty-four patients (38 studies) with possible occult infection were prospectively studied. Patients were imaged 1-4 hr after injection and again at 24 hr postinjection. The early tropolone images had a sensitivity of 53% while the delayed images at 24 hr had a sensitivity of 93%. Based on a previous study, oxine-labeled leukocyte scans have an early sensitivity of 33% and a delayed sensitivity (at 24 hr) of 95%. The differences in sensitivity between oxine and tropolone when imaged early and at 24 hr were not statistically significant. We conclude that there is no significant difference in the ability to detect infection between oxine- and tropolone-labeled leukocytes, both early at 1-4 hr, and on delayed imaging 24 hr after injection.

Topics: Abscess; Adult; Cycloheptanes; False Negative Reactions; Female; Humans; Hydroxyquinolines; Indium; Infections; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Prospective Studies; Radioisotopes; Radionuclide Imaging; Surgical Wound Infection; Time Factors; Tropolone

Topics: Aged; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Suppuration; Uterine Diseases

The use of a 111indium oxine-leukocyte scan (white cell scan) to establish the diagnosis of a pyeloduodenal fistula is described. The patient had a fistula that was associated with spontaneous disappearance of a large staghorn calculus in the involved kidney. The disappearance of the calculus and the presence of a pyeloduodenal fistula were confirmed at surgical exploration. Although neither an excretory urogram nor a retrograde pyelogram was useful to diagnose the fistula preoperatively a 111indium oxine-leukocyte scan revealed the renal abscess and pyeloduodenal fistula.

Topics: Adult; Duodenal Diseases; Humans; Hydroxyquinolines; Indium; Intestinal Fistula; Kidney Calculi; Kidney Diseases; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Radiography; Radionuclide Imaging; Urinary Fistula

Topics: Abdomen; Abscess; Aged; Humans; Hydroxyquinolines; Indium; Male; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Technetium

A simple method is described for estimating the activities bound to leucocytes, erythrocytes, platelets and the free activity, as resulted from the preparation and labelling of leucocytes with 111In-oxine. Measurements are required only of 111In activity, suspension volumes, and platelet concentrations. The limitations of the method are discussed. When blood from a normal volunteer was labelled by an 111In-oxine manufacturer's recommended technique, the greatest proportion of activity was bound to leucocytes, and in addition, a significant proportion of the activity was found to be associated with platelets. If the number of centrifugations between sedimentation and labelling was reduced from two to one, the proportion of free activity increased at the expense of a reduction in leucocyte activity, but the platelet activity remained unchanged. The relative distribution of cell-bound and free activities was independent of the relative centrifugal force (85-450 g), and of the time (15-30 min) and the suspension volume (5-10 ml) used to incubate the cells with 111In-oxine.

Topics: Blood Platelets; Erythrocytes; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Leukocytes; Organometallic Compounds; Oxyquinoline

A method of lymphocyte labeling with 111In-oxine was applied for the diagnosis of acute kidney-graft rejection. After the injection of labeled lymphocytes, scintigrams of the graft area, contralateral iliac fossa, and spleen were obtained. Indexes of activity were calculated. No patient without rejection (n = 3) showed lymphocyte graft deposition. Twenty-two patients with acute graft rejection and two patients with on abdominal-wall abscess over the graft area showed lymphocyte graft trapping. When acute graft rejection was present, index i (graft/contralateral iliac fossa) increased, and index c (spleen/graft) decreased. The improvement after the rejection crisis occurred parallel to the decrease in index i. Index c remained unchange regardless of rejection evolution. In summary, 111In-oxine-labeled lymphocytes may be used for the diagnosis of acute kidney-graft rejection and for evolving control.

Topics: Graft Rejection; Humans; Hydroxyquinolines; Indium; Kidney; Kidney Transplantation; Lymphocytes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Autologous 111In-oxine-labeled granulocytes have proved to be valuable for the localization of inflammatory bowel diseases, especially Crohn's disease and ulcerative colitis. Other rare inflammatory bowel diseases also yield positive 111In scans. One case of Yersinia infection of the terminal ileum (Yersinia enterocolitica) showing an accumulation of 111In-oxine-labeled granulocytes 0.5, 4, and 24 h after the reinjection of the labeled cells is described. The 4-day fecal excretion of 111In-oxine granulocytes showed a slight inflammatory activity of the terminal ileum. One negative scan is reported in a cotrimoxazole-treated patient with Yersinia infection.

Topics: Female; Granulocytes; Humans; Hydroxyquinolines; Ileal Diseases; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Yersinia enterocolitica; Yersinia Infections

We studied the distribution of 111In-labeled peritoneal mononuclear cells (PMC) in Sprague-Dawley rats with carcinosarcoma (CS) tumor. We obtained PMC from normal rats and rats pretreated with BCG or irradiated CS cells as antigenic stimulant. PMC were labeled in-vitro with 111In-oxine and transferred by tail-vein injection to rats bearing CS tumor. Twenty-four, 48 and 72 h after PMC transfer, we measured the accumulation of these cells in the CS tumor as a percentage of dose radioactivity per gram of tumor using an external gamma-ray camera. PMC from normal and BCG treated donor rats accumulated 0.4% and 0.46% dose per gram of CS tumor respectively. PMC from donor rats given killed CS cells accumulated significantly greater concentrations of 111In (0.79% dose per gram of CS tumor, P less than 0.025). Thus killed CS cells were able to sensitize the PMC of normal rats. 111In-oxine-labeling is an elegant procedure to study the distribution of mononuclear cells in tumors.

Topics: Animals; Carcinosarcoma; Female; Hydroxyquinolines; Indium; Kinetics; Macrophages; Monocytes; Organometallic Compounds; Oxyquinoline; Radioisotopes; Rats; Rats, Inbred Strains; Tissue Distribution

Indium 111 platelet imaging for the detection of deep vein thrombosis and pulmonary emboli was performed in 171 patients after abdominal and pelvic surgery. Fifteen patients were found to have inadequate circulating blood pools of indium 111 platelets, making the study nondiagnostic. Of 156 patients with technically satisfactory images, 46 (29.5%) had images consistent with deep venous thrombosis and/or pulmonary emboli. The incidence, time of occurrence, and location of thromboemboli was similar to those of other reports of postoperative patients groups studied by iodine 125 fibrinogen uptake testing. Eighty patients had normal indium 111 platelets and 30 patients had diffusely distributed indium 111 platelets found in the operative field, suggesting accumulation in a postoperative hematoma. None of these results was confused with a diagnosis of deep venous thrombosis. When compared with another accurate diagnostic test in 23 patients, indium 111 platelet imaging was found to have a sensitivity of 100% and specificity of 90%. The technique of indium 111 platelet imaging is performed easily in patients after surgery with some limitations as to the use of donor platelets and the occasionally altered imaging of the operative site. This diagnostic technique enjoys the distinct advantage in that it allows surveillance of the legs, pelvis, abdomen, and chest by a single method, making it a near-ideal method of postoperative thromboembolism surveillance.

Topics: Blood Platelets; Female; Humans; Hydroxyquinolines; Indium; Methods; Organometallic Compounds; Oxyquinoline; Postoperative Complications; Pulmonary Embolism; Radioisotopes; Radionuclide Imaging; Thrombophlebitis

A simultaneous investigation of platelet regeneration time (PRT) based upon malondialdehyde (MDA) recovery after a single oral intake of 500 mg of aspirin and of platelet survival time (PST) after labelling with 51chromium or 111indium oxine was performed in 25 cancerous patients. A pilot study conducted with 9 healthy volunteers demonstrated that the MDA assay was highly reproducible and specific for the platelet cycloxygenase activity. The pattern of MDA recovery after aspirin ingestion was linear in the healthy volunteers and in the patients presenting both a normal and an accelerated platelet turnover. PST were calculated using the four mathematical models recommended by the International Committee for Standardization in Hematology; the best fit was given by the multiple hit model in 22 cases and by the linear regression model in 3 cases. The mean results obtained in the patients investigated with the 51chromium were consistently shorter than those obtained in the patients investigated with the 111indium oxine while the mean PRT were almost identical in the two groups. An excellent correlation between PRT and PST was observed after 111indium oxine labelling and using the weighted mean method for PST determination. These results suggest that the 111indium oxine technique is a better method for platelet labelling and that the results provided by the weighted mean method reflect more closely the in vivo platelet turnover than those provided by the multiple hit model.

Topics: Adult; Aspirin; Blood Platelets; Cell Survival; Chromium Radioisotopes; Female; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Male; Malondialdehyde; Neoplasms; Organometallic Compounds; Oxyquinoline; Radioisotopes; Time Factors

A case of acute tentorial subdural hematoma detected by In-111 leukocyte scintigraphy and confirmed by CT brain scan is herein described. White blood cells are an integral part of the blood pool and labeled white cells freely leave the intravascular space in case of active bleeding. Acute hemorrhage and hematoma can thus be a cause of a false-positive study.

Topics: Aged; Brain Abscess; False Positive Reactions; Hematoma, Subdural; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

The recommended and commonly used methods for the isolation of platelets from whole blood do not harvest a representative platelet population. There is evidence that these methods may result in the loss of a functionally more active platelet subpopulation. We describe a method whereby a completely representative population of platelets was isolated from the whole blood of 28 normal human volunteers by repeated washing of platelets from the red-cell layer. The harvesting efficiency was 98.3% +/- 2.8%. The platelets were labelled with 111In-oxine in a saline milieu with a labelling efficiency of 86.4% +/- 6.8%. The disappearance of reinjected labelled autologous platelets from the circulation was almost linear, and the mean platelet survival was estimated to be 224 +/- 23 h. At equilibrium, 61% +/- 12% of the labelled platelets were recovered from the circulation. The in vivo distribution at equilibrium and the sites of sequestration of the senescent labelled platelets were determined by geometric-mean whole-body quantification in six of the volunteers. This improved method permits accurate quantification of organ 111In radioactivity. Following reinjection, the labelled platelets pooled in the spleen and the accumulated activity can be presented by a single exponential function. At equilibrium, 31.1% +/- 6.1% and 9.6% +/- 1.2% of the platelets were in the spleen and liver, respectively. Splenic and hepatic radioactivity increased significantly with time, and at the end of the platelet life span, 35.6% +/- 9.7% and 28.7% +/- 8.3% of the labelled platelets were sequestrated in these organs, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Blood Platelets; Cell Survival; Female; Heart; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Kinetics; Liver; Male; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Spleen

Indium-114m and 114In appear as contaminants in commercial preparations of [111In]oxine at a level of about 0.05% at time of calibration (TOC). The contribution of these contaminants to the radiation absorbed dose from [111In]oxine leukocyte, platelet, and erythrocyte imaging procedures has been evaluated. When the absorbed dose from these contaminants is expressed as a percent of the 111In dose to the same organ from a given procedure, the contaminants contribute an additional 0.16 to 12% of the 111In dose, and in one case, that of the spleen from [111In]oxine labeled erythrocytes, they contribute an additional 33%. Commercial samples of aqueous-based [111In]oxine contain levels of 114mIn/114In sufficient to result in a mild to moderate increase in the absorbed radiation dose to the patient. Strict quality control procedures must be maintained by suppliers to prevent higher contamination levels. It is advisable to avoid using 111In products of this nature later than about 3 days after the time of calibration.

Topics: Blood Platelets; Drug Contamination; Erythrocytes; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Radiation Dosage; Radioisotopes

Topics: Adult; Colitis, Ulcerative; Colon; Crohn Disease; Female; Humans; Hydroxyquinolines; Ileum; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

At least one microCi of 111indium oxine (111InOx) could be incorporated into 10(6) human tumor cells without cytotoxicity as determined by colony assay or by trypan blue staining. 111In bound to prekilled cells was removed preferentially by washings, and prelabeled cells killed with diphtheria toxin released radioactivity much more rapidly than did viable cells. The metal chelator calcium disodium edetate did not facilitate 111In removal from either viable or dead cells. High sensitivity can be obtained for in vitro or in vivo cytotoxicity assays using human cells prelabeled with 111InOx.

Topics: Animals; Cell Line; Cell Survival; Deoxyuridine; Diphtheria Toxin; Edetic Acid; Half-Life; Humans; Hydroxyquinolines; Indium; Iodine Radioisotopes; Isotope Labeling; Mice; Mice, Nude; Neoplasms; Organometallic Compounds; Oxyquinoline; Radioisotopes

The localization of In-111 labeled leukocytes (WBCs) in recent surgical incisions was studied in 18 patients. In-111 WBC images correlated well with culture results and clinical findings. No accumulation of In-111 WBCs was detected at the site of noninfected incisions in nine patients. In-111 WBCs did accumulate at incision sites in nine patients with infected surgical incisions. These results indicate that In-111 WBC study can accurately distinguish between normal healing and infection of recent surgical incisions.

Topics: Adult; Aged; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Surgical Wound Infection; Wound Healing

Polymorphonuclear leucocytes (PMN) from normal human subjects were labelled with [111In]oxine (20 muCi 10(8) cells). In the presence of 20% autologous serum (AS), dissociation of 111In from the cells resulted in mean losses of radioactivity of 13% at 3 h and 30% at 24 h. Adherence of 111In-labelled PMN to cultured porcine endothelial monolayers was increased by 40.7 +/- 31.6% after 60 min incubation in 20% AS at 37 degrees C when compared with unlabelled cells. Phagocytosis and intracellular killing of Candida albicans were unaltered by labelling. Elution of 111In from labelled PMN together with enhanced adhesiveness may have important implications for the study of PMN kinetics and the investigation of inflammatory disease.

Topics: Cell Adhesion; Cell Survival; Humans; Hydroxyquinolines; Indium; Kinetics; Neutrophils; Organometallic Compounds; Oxyquinoline; Phagocytosis; Radioisotopes

Intracardiac and arterial thrombi were examined by scintigraphy using In-111-oxine labeled autologous platelets. In 22 cases of myocardial infarction including six with ventricular aneurysms, four had positive findings of thrombi on imaging and detected also by echocardiography. All four had ventricular aneurysms. The so-called "moya-moya" echoes (fuzzy echoes) were demonstrated in two of these four cases. We encountered two cases with positive findings on imaging in 13 with mitral valve disease. These two had systemic embolic episodes after scintigraphic examination. "Moya-moya" echoes were detected in the left atrial cavity in four with negative findings on imaging. Positive images were obtained in two of three with acute arterial occlusive disease, and in both cases platelet deposition was observed in the proximal site of obstruction. Though thrombectomy was performed for one of these two cases, no thrombus was detected at the site of platelet deposition. After one month, re-examination revealed only negative findings in all sites in both these patients. In the six cases of aortic aneurysm, three had platelet deposition within their aneurysms, and surgery was performed for these positive cases, but one of them had no thrombus. Positive images were obtained in only one of seven patients with chronic arterial occlusive disease. Coagulation tests and platelet studies were investigated for patients with positive or negative platelet scans. Only the data of the thrombo-test showed a significant difference (97 +/- 9% vs 23 +/- 7%, p less than 0.001). Three cases of positive imaging became negative after anticoagulant therapy. We tried ECT for eight cases 24 hours after injection of In-111-oxine labeled platelets. Three cases showed clear images of thrombi, while the planar images could not detect them at an early stage. Therefore, we propose that ECT can be a useful technique for diagnosing intracardiac thrombi in early stage.

Topics: Aged; Arterial Occlusive Diseases; Blood Platelets; Child; Child, Preschool; Heart Diseases; Humans; Hydroxyquinolines; Indium; Infant; Infant, Newborn; Male; Myocardial Infarction; Organometallic Compounds; Oxyquinoline; Thrombosis; Tomography, Emission-Computed

A 61-year-old white female with ulcerative carcinoma of the sigmoid exhibited an abscess-like pattern on a white blood cell scan using 111In-oxine-labeled 'pure' granulocytes. Constant 111In activity could be seen in the tumor 0.5, 3, and 20 h after the reinjection of the labeled cells. The absence of an abscess was proven by surgery and histological investigation.

Topics: Abdomen; Abscess; Adenocarcinoma; Diagnosis, Differential; Female; Granulocytes; Humans; Hydroxyquinolines; Indium; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Sigmoid Neoplasms; Time Factors

Patients with Crohn's disease (n = 22), ulcerative colitis (n = 5), inactive Whipple's disease (n = 1), irritable bowel syndrome (n = 2), arthritis (n = 1) and Yersinia infections (n = 2) were examined with 111In-oxine labelled "mixed" leukocyte preparations (n = 12) or with 111In-oxine labelled "pure" granulocyte preparations (n = 21). Compared with barium enemas of the gut and colonoscopy, performed within of one week in 31 patients there was a correct location of infiltrated bowel segments in 24 patients (78%). The scan diagnosed more infiltrated segments in 4 patients (13%). In 3 patients it failed to diagnose one inflamed segment. In 24 patients the faecal 111In-excretion was expressed as percentage of the reinjected 111In-activity. All patients with non inflammatory bowel diseases and patients with inactive inflammatory bowel diseases excreted less than 2% of the reinjected 111In-activity. All but one female patient with active bowel disease excreted more than 2%. In 24 patients the correlation of ESR, CDAI and A.I. was available. There was a good correlation between ESR (r = 0.77, P less than 0.001), A.I. (r = 0.61, p less than 0.001) and the %-faecal faecal excretion. The 111In-labelling of white blood cells, especially of granulocytes, seems to be a reliable alternative method to localize infiltrated bowel segments and to assess disease activity in patients with inflammatory bowel diseases, compared to usually performed radiological, endoscopical and clinical methods.

Topics: Adult; Aged; Colitis, Ulcerative; Colon; Crohn Disease; Female; Granulocytes; Humans; Hydroxyquinolines; Ileum; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Rectum

Topics: Humans; Hydroxyquinolines; Indium; Isotope Labeling; Leukemia, Myeloid, Acute; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Skin Neoplasms

For 52 patients with cardiac disease and 11 patients with vascular disease, In-111-oxine platelet scintigraphy was performed to assess its clinical usefulness for detecting thrombi. Using Hayashida's method, platelets were separated in 43 ml peripheral blood, washed and labeled with 1 mCi In-111-oxine. In addition to planar images in the anterior, 45 degrees left anterior oblique and left lateral views, single photon emission computed tomography (SPECT) was performed in some cases by rotating a dual gamma camera 24 and 72 hours after labeled platelet injection. The functions of platelet and coagulability were examined 36 hours after the injection of labeled platelets. Medical therapy was not changed during this study. Intracardiac thrombi were documented in 16 of 52 cases with cardiac disease and intravascular thrombi in 10 cases with vascular disease by angiography, CT and two-dimensional echocardiography. Positive images were obtained in 10 cases with cardiac disease and in eight cases with vascular disease by scintigraphy. Therefore, sensitivity, specificity, and overall accuracy were 63%, 100% and 88% in intracardiac thrombi; 80%, 100% and 82% in intravascular thrombi; and totally 69%, 100% and 87%, respectively. In the detection of intracardiac thrombi by scintigraphy, the sensitivity seemed to be lower and the specificity higher than those by other graphic studies. In 52 cases with cardiac disease, five out of six cases with false negative images had received antiplatelet and/or anticoagulant drugs, and in these cases, platelet and coagulation functions tended to be decreased compared with those of true positive cases or true negative cases. We conclude that positive images in scintigraphy indicate the existence of growing thrombi, and that In-111-oxine platelet scintigraphy has clinical usefulness, not only for detecting thrombi, but for estimating platelet activity and effect of medical therapy.

Topics: Blood Platelets; Female; Heart Diseases; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Thrombosis; Tomography, Emission-Computed

Topics: Blood Platelets; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Organometallic Compounds; Oxyquinoline; Sterilization

The range of leucocyte labelling efficiencies with 111In-oxine for a group of patients extended significantly (P = 0.05) below that obtained for a series of labellings of the same normal blood from a volunteer. A retrospective analysis was made of the results in the two groups to identify the cause of this difference in range. The labelling efficiency for patients did not vary with the volume of 111In-oxine, and was independent of the whole blood leucocyte concentration. The difference between the average labelling efficiencies obtained for a group of patients and the normal series labelled by the same operator was more significant than the difference in average labelling efficiencies obtained by different operators. It was concluded that biological variation in patients' blood, rather than operator technique, must have been a more important cause to the difference in the labelling efficiency range between patients and normal. It was also concluded that variations of contaminant platelet-bound activity and of plasma viscosity were greater in the patient group than the normal series, and contributed to this difference in labelling efficiency range.

Topics: Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Organometallic Compounds; Oxyquinoline

The use of 111Indium oxine as a platelet label for the performance of platelet life-span studies has been examined. Platelet life-span in normal subjects varied between 8 X 10 and 10 X 36 d. Patients with primary thrombocythaemia had clearly reduced platelet life-span whether or not they presented with vascular occlusion and this abnormality persisted after reduction of the platelet count to normal by busulphan therapy. Patients with similarly elevate platelet counts due to chronic granulocytic leukaemia or after splenectomy had platelet life-span values in the normal range. Plasma beta-TG levels could not be used to predict platelet life-span in these groups of patients. Measurement of platelet life-span using 111Indium labelled platelets is a useful technique in the examination of platelet function in occlusive vascular disease.

Topics: Adult; Aged; beta-Thromboglobulin; Blood Platelets; Cell Survival; Humans; Hydroxyquinolines; Indium; Leukemia, Myeloid; Lymphoma; Male; Middle Aged; Myeloproliferative Disorders; Organometallic Compounds; Oxyquinoline; Platelet Count; Polycythemia Vera; Radioisotopes; Splenectomy; Thrombocytosis; Time Factors

The present paper compares scintigraphy using leucocytes labelled with 111 indium oxine sulphate with conventional 99Tc pyrophosphate scintigraphy for the investigation of inflammatory processes in the region of the jaw bones. It also tries to establish whether progress can be made in the field of differential diagnosis using a combination of these two methods of investigation. It is shown that conventional scintigraphy using 99Tc pyrophosphate represents an approved method of investigation, whereas scintigraphy using autologous leucocytes does not as yet fulfil the expectations that have been placed in it.

Topics: Abscess; Bone Cysts; Diphosphates; Granulocytes; Humans; Hydroxyquinolines; Indium; Jaw Diseases; Maxillary Sinus; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Sinusitis; Technetium; Technetium Tc 99m Pyrophosphate

A precise method for quantitation of polymorphonuclear leukocyte (PMNL) accumulation in skin in vivo, has been developed so that the proinflammatory effects of various agents can be compared. This method can also be used to evaluate the effect of therapeutic agents on PMNL accumulation in vivo. Rabbit PMNLs were purified from heparinized blood by dextran sedimentation, hypotonic lysis, and separation on Ficoll-Hypaque. The PMNLs were labeled with 3-5 microCi per 10(6) cells of 111In oxine and reinfused coincidentally with different concentrations of different chemotactic and proinflammatory materials injected intradermally into the back. In some experiments, varying concentrations of acetic acid were applied topically. Four to 18 hours later, the rabbits were sacrificed. Eight-millimeter punch biopsies were obtained from the injection sites and counted in a gamma counter. The number of PMNLs infiltrating the dermis was also quantitated in histologic sections. A significant correlation was found between the percent increase in radioactivity and the percent increase in PMNL accumulation morphologically. Dose-response curves were generated using such proinflammatory materials as formyl-methionyl-leucyl-phenylalanine, lipopolysaccharide, activated serum, trypsin, glycogen, and acetic acid. These curves were highly reproducible from animal to animal. Using this assay, we found that as little as 1 microgram of trypsin induced detectable PMNL accumulation. This is 2-3 logs more sensitive than injecting mice intraperitoneally with trypsin. Diisopropyl fluorophosphate-inactivation of trypsin inhibited PMNL accumulation. This sensitive and quantitative bioassay of PMNL accumulation permits evaluation of multiple agents in the same animal, which decreases animal to animal variation.

Topics: Acetates; Acetic Acid; Animals; Biological Assay; Cell Count; Dose-Response Relationship, Drug; Glycogen; Hydroxyquinolines; Indium; Lipopolysaccharides; N-Formylmethionine Leucyl-Phenylalanine; Neutrophils; Organometallic Compounds; Oxyquinoline; Rabbits; Radioisotopes; Skin; Trypsin

A method for the concentration of leucocytes from blood and labelling of the separated cells with 111-Indium oxine is described. This method guaranteed a good preparation. On average there were 64.8% of leucocytes from the blood in the concentrate. The yield of the labelling averaged 93%. Seventy-two patients from various departments were examined to test the clinical application of the labelled leucocytes in the diagnosis of inflammatory diseases. The results obtained led to the formulation of six indications for the appropriate application of leucocyte scanning in everyday clinical routine.

Topics: Adolescent; Adult; Aged; Bone Diseases; Brain Diseases; Child; Humans; Hydroxyquinolines; Indium; Inflammation; Isotope Labeling; Leukocytes; Middle Aged; Neuromuscular Diseases; Organometallic Compounds; Oxyquinoline; Radiation Dosage; Radioisotopes; Radionuclide Imaging; Urologic Diseases

Imaging with leukocytes labeled with indium-111 oxine is a sensitive technique for detecting sites of occult infection. Traditionally, imaging is performed 24 hr after injection. We undertook a prospective study of 35 patients (40 studies) with possible occult infection to see whether a 24-hr delay in imaging is really necessary. Patients were imaged at 1-4 hr and again at 24 hr after injection. The early images had a sensitivity of only 33%, compared with 95% for the 24-hr images. Of the seven studies that were positive on both early and delayed images, 71% had more intense uptake at 24 hr. There were no false-positive early images. We conclude that imaging 1-4 hr after injection with In-111 oxine-labeled leukocytes has a low sensitivity for detecting occult infection. However, a positive early image is specific for a site of infection.

Topics: Adult; Aged; Bacterial Infections; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Subphrenic Abscess; Time Factors

In-111 oxine labeled white cells were used to diagnose acute inflammatory conditions in 42 children and adolescents, aged 6 weeks to 19 years. In 43 scans where a clinical correlation could be made, the test had a sensitivity of 81% and a specificity of 94%. There were no adverse reactions. For children the dose of In-111 recommended is 10-12 mu Ci/kg body weight to a maximum of 500 mu Ci.

Topics: Abscess; Acute Disease; Adolescent; Adult; Arthritis, Infectious; Child; Child, Preschool; False Negative Reactions; Female; Humans; Hydroxyquinolines; Indium; Infant; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Radiation Dosage; Radioisotopes; Radionuclide Imaging

The radiopharmaceuticals gallium-67 and indium-111 labelled leucocytes have been compared in 15 patients with a painful joint prosthesis in an attempt to identify those patients with periprosthetic infection. Gallium-67 images were abnormal in five out of six patients with periprosthetic infection and normal in seven out of nine without evidence of infection. Indium-111 leucocyte images were abnormal in three out of six patients with infection and normal in all nine patients without infection. Indium-111 labelled leucocyte imaging is technically more difficult to perform than gallium-67 imaging. This, combined with the higher sensitivity of gallium-67 imaging for infection around a prosthetic joint, leads us to conclude that gallium-67 imaging is superior to indium-111 leucocyte imaging in identifying infection as a cause of a painful prosthetic joint.

Topics: Adult; Aged; Bacterial Infections; Female; Gallium Radioisotopes; Hip Prosthesis; Humans; Hydroxyquinolines; Indium; Joint Prosthesis; Knee Prosthesis; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pain, Postoperative; Pelvis; Postoperative Complications; Radioisotopes; Radionuclide Imaging

The accuracy and usefulness of indium-111 oxine-labeled autologous leukocyte scans in the management of infectious complications of colon and rectal surgery and of inflammatory diseases of the colon have been studied by review of the records of all patients undergoing such scans at Morristown Memorial Hospital during the first six months such scans were performed there. A total of 20 scans was performed on 18 patients. Twelve scans were performed on 11 patients being treated for diseases of the colon and rectum. Of these 12 scans, one was normal, four demonstrated intra-abdominal abscesses, three demonstrated wound infections (two abdominal, one perineal), one was positive for granulomatous colitis, one for pseudomembranous colitis, one for chronic diverticulitis, and one for enterocutaneous fistula. One allergic reaction to the labeled leukocytes occurred. Comparisons with other corroborative localizing diagnostic tests were made. Subsequent treatment was reviewed. Analysis of these cases indicates that the majority of all scans were performed to evaluate complications of colorectal surgery or inflammatory diseases of the colon and that these scans were highly accurate. In all instances where appropriate, delineation of a lesion in the colorectal cases was followed by corrective treatment.

Topics: Abdomen; Abscess; Colitis; Colonic Diseases; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Rectal Diseases; Surgical Wound Dehiscence; Surgical Wound Infection

Using 111indium oxine and 111indium oxine sulphate as platelet labels, maximal labelling efficiency can be achieved already after 3 minutes at an incubation temperature of 37 degrees C. Mean labelling efficiency values of about 90% are reached at a platelet count of greater than 10(9) platelets/ml, but the labelling efficiency is satisfactory also at a rather low platelet count of about 10(6) platelets/ml (71% on average). Platelet labelling with these tracers allows the calculation of platelet half-life in vivo, and gamma-camera imaging of platelet aggregates in thrombosis and renal transplant rejection as well. In the present study, the platelet half-life is significantly shortened in patients with coronary heart disease (n = 15), peripheral vascular disease (n = 13) and primary hyperlipoproteinaemia (n = 32) in comparison with 106 controls. No age dependence of platelet half-life was found in the different groups of patients whereas in the control group, a significant negative correlation between age and platelet half-life was observed.

Topics: Adult; Age Factors; Aged; Arteriosclerosis; Blood Platelets; Coronary Disease; Half-Life; Humans; Hydroxyquinolines; Hyperlipoproteinemias; Indium; Isotope Labeling; Methods; Microscopy, Electron, Scanning; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

The optimal conditions for red blood cell labelling using 111indium oxine, 111indium oxine sulphate and 99mTc oxine were established both in vitro as well as in vivo. The coagulant had no effect on labelling efficiency. Other variables such as the incubation time, temperature, duration, cell number and concentration of the complex exert a significant influence on labelling efficiency. Labelling efficiency of red blood cells is very high also under non-optimum conditions as compared with other cells (leucocytes, platelets).

Topics: Erythrocytes; Humans; Hydroxyquinolines; In Vitro Techniques; Indium; Organometallic Compounds; Organotechnetium Compounds; Oxyquinoline; Radionuclide Imaging; Technetium; Temperature; Time Factors

Autologous leukocytes labeled with In-111 oxine (ILL) concentrated in the renal allografts of eight patients for whom transplant rejection, infection, or acute tubular necrosis (ATN) could be excluded. All patients had good-to-adequate renal function at the time of ILL scintigraphy, and none developed rejection or renal transplant failure during a 1-mo follow-up period. It is concluded that normally functioning renal allografts without evidence of rejection, infection, or ATN often will concentrate ILL. When a baseline study is not available for comparison, this phenomenon limits the value of ILL scintigraphy as a diagnostic test for transplant rejection or infection.

Topics: Adult; Follow-Up Studies; Graft Rejection; Graft Survival; Humans; Hydroxyquinolines; Indium; Kidney; Kidney Transplantation; Leukocytes; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Time Factors; Transplantation, Homologous

Topics: Adolescent; Adult; Blood Platelets; Diabetes Mellitus, Type 1; Diabetic Nephropathies; Female; Graft Rejection; Humans; Hydroxyquinolines; Indium; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pancreas; Pancreas Transplantation; Radioisotopes; Radionuclide Imaging

Topics: Animals; Blood Platelets; Dogs; Graft Rejection; Hydroxyquinolines; Indium; Organometallic Compounds; Oxyquinoline; Pancreas; Pancreas Transplantation; Radioisotopes; Radionuclide Imaging; Time Factors

One hundred twenty-nine 111In-oxine-labeled leukocyte scintiscans have been performed in 117 patients with cancer in order to diagnose localized infectious disease. Of the 115 contributive scans, 40 were in patients with localizing signs, whereas in 75 fever of unknown origin constituted the indication for this examination. The overall specificity of the method was 95.4%, the overall sensitivity 86%, and the global accuracy 91.3%. In 10 cases with localizing signs, the 111In-oxine granulocyte scintigram allowed exclusion of the diagnosis of infection, whereas in 17 instances without localizing signs, a focal infectious process was demonstrated. Heterologous donor leukocytes were used successfully in five instances. With the exception of accumulation of label at the site of an osteolytic metastasis in one case, no uptake was observed in primary or secondary tumors. It is concluded that 111In-oxine-labeled leukocytes constitute a valuable tool in the diagnosis and localization of infection in patients with malignant disease.

Topics: Bacterial Infections; Bone Neoplasms; Diagnosis, Differential; False Negative Reactions; Female; Humans; Hydroxyquinolines; Indium; Leukemia, Lymphoid; Leukocytes; Liver Neoplasms; Lymphoma; Neoplasms; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Rectal Neoplasms; Uterine Cervical Neoplasms

A 4-year-old boy presented with consumptive coagulopathy suspected to be due to Kasabach-Merritt syndrome. Localization of homologous indium-111 platelets in the region of the right sacral ala confirmed that this was the site of disease and facilitated radiation treatment, which proved to be curative.

Topics: Blood Platelets; Child, Preschool; Hemangioma; Humans; Hydroxyquinolines; Indium; Male; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Spinal Neoplasms; Syndrome; Thrombocytopenia

A simple technique of autologous platelet labelling is described, which allows labelling within 40 min, and has the advantage of low costs, as no laminar air flow is required. Blood (16 ml) was withdrawn into 4 ml ACD, 500 ng prostacyclin was added. After 10 min sedimentation the vials were centrifuged for 5 min at 150 g. The plateletrich plasma in the supernatant was centrifuged at 500 g for 10 min to obtain a platelet pellet. The platelet-poor plasma was preserved in a sterile syringe and the platelet pellet was resuspended in 1 ml tyrode buffer. The cell suspension was labelled at 37 degrees C for 5 min with 100 muCi 111In-oxine sulphate and reinjected after dilution with the plasma. Mean labelling efficiency was 90% +/- 3%, mean recovery 2 h after reinjection 76% +/- 3% (mean +/- SD).

Topics: Blood Platelets; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Organometallic Compounds; Oxyquinoline; Sterilization

Topics: Adult; Aged; Bone Marrow; Female; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Kinetics; Leukemia, Myeloid, Acute; Male; Middle Aged; Organometallic Compounds; Oxyquinoline

Topics: Blood Volume Determination; Erythrocytes; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Spleen

Loss of radioactivity from nude mice was determined after inoculation of human tumor cells prelabeled with [111In]indium oxine (111InOx). Elimination of 111In was increased somewhat by treating the mice with diphtheria toxin (DT), which is toxic selectively for human cells compared to mice. Calcium disodium edetate (CaNa2EDTA), a metal chelating agent, facilitated elimination of 111In and increased the difference in the rates of loss of radioactivity from mice bearing viable compared to DT-killed cells.

Topics: Animals; Cell Line; Cell Survival; Diphtheria Toxin; Edetic Acid; Humans; Hydroxyquinolines; Indium; Kinetics; Melanoma; Mice; Mice, Nude; Neoplasm Transplantation; Organometallic Compounds; Oxyquinoline; Radioisotopes; Teratoma; Transplantation, Heterologous

Topics: Agranulocytosis; Granulocytes; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

The migration pattern of lymphocytes labelled with indium-111 was followed in a patient with B cell non-Hodgkin's lymphoma treated with a murine monoclonal anti-idiotype antibody. During the early phase of continuous infusion of antibody rapid fluxes of labelled lymphocytes into and out of the blood were seen. Dynamic scanning showed immediate uptake in the lungs; thereafter activity decreased in the lungs and increased in the liver. Studies of labelled and unlabelled cells in the circulation showed that treatment resulted in the removal of lymphocytes from the blood which was repopulated from an extravascular compartment. Tumour cells were shown to be cleared from the blood by the reticuloendothelial system in the liver. Indium-111 should be used circumspectly because it may cause chromosomal damage in labelled cells, but it is clearly useful as a radiolabel for following the migration pathways of lymphocytes in vivo.

Topics: Aged; Antibodies, Monoclonal; B-Lymphocytes; Cell Movement; Female; Humans; Hydroxyquinolines; Immunoglobulin Idiotypes; Indium; Leukocyte Count; Lymphocytes; Lymphoma, Non-Hodgkin; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Time Factors

Topics: Animals; Blood Platelets; Blood Vessel Prosthesis; Dogs; Hydroxyquinolines; Indium; Infections; Organometallic Compounds; Oxyquinoline; Radioisotopes

Since indium-111 platelet scintigraphy for the detection of left ventricular thrombosis often shows considerable non-specific blood pool activity a subtraction method using simultaneous technetium-99m blood pool scintigraphy was undertaken in 11 subjects with well documented remote myocardial infarction, who served as positive or negative controls, and in 18 consecutive patients with acute myocardial infarction. The results were compared with those of cross sectional echocardiography. Thirteen patients had transmural myocardial infarction and the calculated count per pixel in the left ventricle of the subtracted indium-111 platelet scintigram was (mean (SD)) 0.28(0.35), but five patients with subendocardial myocardial infarction had a mean count of 0.04(0.06). In seven patients with transmural myocardial infarction (two anterior and five inferior) left ventricular thrombosis was detected by indium-111 platelet scintigraphy but in only one of these by cross sectional echocardiography. None of the patients with subendocardial myocardial infarction had left ventricular thrombosis. Subtracted left ventricular counts correlated well with the visual results. It is concluded that left ventricular platelet sequestration after acute myocardial infarction may be quantified and precisely located and that quantitative longitudinal studies of the natural history and drug intervention are now possible.

Topics: Adult; Aged; Blood Platelets; Echocardiography; Female; Heart; Heart Ventricles; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Myocardial Infarction; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Subtraction Technique; Thrombosis

Recent reports have indicated a possible role for 111Indium leucocyte scintigraphy in the management of patients with acute inflammatory bowel disease. Our experience with this technique in 15 patients (nine with ulcerative colitis, six with Crohn's disease) is described. Perfect agreement was not obtained between scintigraphic appearances and other conventional means in the assessment of extent of disease. Good correlation, however, was found between disease activity and recovery of labelled leucocytes in the faeces. While this latter finding could be used as an objective means of assessing response to therapy, it is concluded that conventional indium scintigraphy, using indium oxine-labelling of mixed leucocytes, is insufficiently reliable to replace usual methods for determining extent of disease in patients with inflammatory bowel disease.

Topics: Colitis, Ulcerative; Crohn Disease; Evaluation Studies as Topic; Feces; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Prednisolone; Radioisotopes; Radionuclide Imaging

Topics: Abscess; Adult; Aged; Enterocolitis, Pseudomembranous; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Peritoneal Diseases; Radioisotopes; Radionuclide Imaging

Topics: Escherichia coli; Humans; Hydroxyquinolines; Indium; Organometallic Compounds; Oxyquinoline; Radioisotopes; Staphylococcus aureus

Topics: Humans; Hydroxyquinolines; Indium; Isotope Labeling; Leukocytes; Organometallic Compounds; Oxyquinoline; Radioisotopes; Time Factors; Transferrin

This study was designed to evaluate the efficacy of scintigraphy by using 111In-oxine labeled platelets for the detection of either intracardiac or intravascular thrombi. Fourteen cases of thrombi diagnosed or suspected on the basis of either angiography or two-dimensional echography were examined. They included four cases of left ventricular thrombi, three of left atrial thrombi, four of vascular thrombi and three of inflammatory disease. Platelet samples from the patients were labeled by 111In-oxine according to the method originated by Yui et al. The labeling efficiency was 72.4 +/- 9.8%. The platelets retained good function except for collagen aggregability. Hot areas of high quality in the scintigram were demonstrated in six cases including two with left ventricular thrombi, two with left atrial thrombi and two with vascular thrombi. These areas accorded well with the findings of angiography, echography or surgery. The removed thrombi had a layer of aggregated platelets on the surface. Platelet survival was shortened in a case of prosthetic valve endocarditis without a hot area, and was normal in four out of five cases including two with a hot area. It is concluded that this method is potentially predictive in detecting thrombi.

Topics: Adult; Aged; Aortic Aneurysm; Blood Platelets; Cardiomyopathy, Dilated; Female; Heart Atria; Heart Diseases; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pulmonary Embolism; Radionuclide Imaging; Takayasu Arteritis; Thrombosis

Platelet scintigraphy was performed on 62 patients with cerebral ischaemia. Pathological scintigraphic images were obtained in 29 of the 62 patients. In 79.3% of these 29 patients the scan was abnormal in the vessel clinically affected. Platelet scintigraphy was abnormal in 21 of 34 patients with normal angiogram or only slight atherosclerosis. In patients undergoing antiplatelet therapy, platelet scintigraphy was less often positive than in untreated patients. It is suggested that platelet scintigraphy could be an appropriate technique for detecting small mural thrombi of the carotid artery, which are the source of arterio-arterial emboli, and for controlling the efficiency of antiplatelet therapy.

Topics: Adult; Aged; Blood Platelets; Cerebral Angiography; Cerebrovascular Disorders; Female; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Platelet Aggregation; Radioisotopes; Radionuclide Imaging

Canine vascular endothelium labeled with indium-111-oxine was used as a marker of cell attachment to vascular prosthetic surfaces with complex textures. Primarily cultured and freshly harvested endothelial cells both took up the label rapidly. An average of 72% of a 32 micro Ci labeling dose was taken up by 1.5 X 10(6) cells in 10 min in serum-free medium. Over 95% of freshly labeled cells were viable by trypan blue tests and only 5% of the label was released after 1 h incubations at 37 degrees C. Labeled and unlabeled cells had similar rates of attachment to plastic dishes. Scanning electron microscopic studies showed that labeled cells retained their ability to spread on tissue culture dishes even at low (1%) serum levels. Labeled endothelial cells seeded onto Dacron or expanded polytetrafluoroethylene vascular prostheses by methods used in current surgical models could be identified by autoradiography of microscopic sections of the prostheses, and the efficiency of cell attachment to the prosthesis could be measured by gamma counting. Indium-111 labeling affords a simple and rapid way to measure initial cell attachment to, and distribution on, vascular prosthetic materials. The method could also allow measurement of early cell loss from a flow surface in vivo by using external gamma imaging.

Topics: Animals; Autoradiography; Blood Vessel Prosthesis; Cell Adhesion; Cell Survival; Dogs; Endothelium; Hydroxyquinolines; Indium; Organometallic Compounds; Oxyquinoline; Polyethylene Terephthalates; Radioisotopes

Topics: Abscess; Diagnostic Errors; Humans; Hydroxyquinolines; Indium; Inflammation; Leukocytes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

The usefulness of In-111 oxine labeled autologous platelets in the diagnosis of renal graft rejection was studied. The method is based on imaging of the graft area at 4, 24, 48, and 72 hours after the injection of the labeled cells. The study was done in 31 renal transplant recipients. The control group included four patients with normal renal function without evidence of rejection. No platelet uptake was observed in any of them. The study group included 22 patients with acute rejection which was confirmed histologically in 13. One case of chronic vascular type rejection of the graft tracer uptake was seen. There was a false-positive result due to a perirenal hematoma. In three patients with a non-immunological sudden impairment of renal function, no activity was detected in the graft area. We also evaluated the changes in platelet trapping throughout the study and they seemed to correlate with the response to the antirejection therapy.

Topics: Adult; Blood Platelets; Evaluation Studies as Topic; False Positive Reactions; Female; Graft Rejection; Humans; Hydroxyquinolines; Indium; Kidney; Kidney Transplantation; Kidney Tubular Necrosis, Acute; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Time Factors

Clearance of IV-injected tumor cells has been correlated with levels of natural killer (NK) cell activity in recipient animals. Studies of in vivo tumor cell clearance strongly suggest a relationship between levels of NK cell activity and antitumor or antimetastatic effector function. This study outlines the applicability of three radiolabels, [125I]iododeoxyuridine, ( [125I]dUrd), indium-111-oxine chelate ( [111In]Ox), and chromium-51 (51Cr), to studies of tumor cell clearance in vivo. The suitability of these labels for analysis of the in vivo migration patterns of normal lymphocytes or thymus-derived T cells cultivated in vitro (CTC) is also discussed. The results indicate that [111In]Ox and 51Cr compare favorably with the more widely used [125]dUrd as radiolabels for the assessment of IV-injected tumor cell clearance from the lungs of mice. The rates of clearance of both [111In]Ox and 51Cr, like that for [125I]dUrd, correlate closely with levels of NK-cell activity of the host. Further studies with [111In]Ox reveal that treatment of recipients with anti-asialo GM1 serum, a regimen known to suppress NK-cell activity, demonstrates the appropriate reduction in isotope clearance from the lungs after NK suppression. However, clearance data obtained by monitoring levels of radioactivity in the liver after IV injection must be viewed cautiously, since the same cells labeled with [111In]Ox and [125I]dUrd had a different pattern of clearance from the liver. The same inconsistencies in clearance were observed when [111In]Ox and [125I]dUrd were injected intrafootpad (i.f.p.). Similar effects were observed when [111In]Ox or 51Cr was applied to studies of CTC migration. Levels of [111In]Ox and 51Cr remained high in the liver after IV injection, while [125I]dUrd was rapidly cleared. Normal spleen or thymic lymphocytes exhibited the expected homing to the spleen after labeling with [111In]Ox, indicating a suitability of this label for migration studies, except possibly in the liver. These results with CTC and normal lymphocytes should be considered during the formulation of immunotherapy protocols based on cell migration data, since the choice of radiolabel can result in widely divergent levels of radioactivity accumulated in some organs, and may not provide an accurate representation of the presence of viable, intact, or functional cells.

Topics: Animals; Chromium; Chromium Radioisotopes; Female; Hydroxyquinolines; Idoxuridine; Immunity, Innate; Indium; Iodine Radioisotopes; Lymphocytes; Lymphoma; Mast-Cell Sarcoma; Mice; Mice, Inbred Strains; Neoplasms, Experimental; Organometallic Compounds; Oxyquinoline; Radioisotopes; T-Lymphocytes; Tissue Distribution

We have used homologous platelet labelling with 111In oxine in the diagnosis of thrombocytopenia occurring in a patient who had received two renal transplants. The technique enabled us to prove that platelet destruction was occurring in the right-sided, non-functioning transplant. In the presence of moderately impaired bone marrow function, this destructive process was sufficient to cause thrombocytopenia. Transplant nephrectomy relieved the thrombocytopenia.

Topics: Blood Platelets; Cell Survival; Female; Graft Rejection; Humans; Hydroxyquinolines; Indium; Kidney Transplantation; Middle Aged; Organometallic Compounds; Oxyquinoline; Platelet Count; Radioisotopes; Radionuclide Imaging; Thrombocytopenia

Topics: Blood Platelets; Humans; Hydroxyquinolines; Indium; Occupational Diseases; Organometallic Compounds; Oxyquinoline; Pentanones; Radiation Protection; Radiodermatitis; Radioisotopes; Radionuclide Imaging

High activity labeled platelets could be useful for the detection and observation of small foci of thrombosis by gamma-camera imaging. Therefore platelets were labeled with 111In-oxine containing increasing activities of 111In to determine the elimiting amount of this tracer that did not cause cell damage. A labeling procedure was employed so that all the chemical parameters remained constant except the amount of 111In. Platelet damage was studied by ADP-induced aggregability according to the Born procedure and by scanning and ultrastructural electron microscopy. Platelets labeled with the lowest activity 2.2 MBq/ml of platelet suspension (10(9) cells/ml) showed no alterations. With the highest activity studied, (22 MBq/ml) aggregability decreased by two-thirds and great changes in the shape of the platelets were seen by electron microscopy. These modifications were attributed to the decay of 111In predominantly located in the platelet cytosol. Labeling of platelets with an activity higher than 7.4 MBq/ml is unsuitable for detection of thrombosis since normal platelet functions are not retained.

Topics: Blood Platelets; Coronary Disease; Humans; Hydroxyquinolines; Indium; Organometallic Compounds; Oxyquinoline; Platelet Aggregation; Radionuclide Imaging

Indium 111 oxine is currently used to label peripheral lymphocytes in order to study the kinetics of these cells in vivo. Since the quantity of radioisotope for labelling is still a matter of controversy, we have investigated in vitro the effect of increasing the concentration of indium 111 oxine on the lymphocyte surface phenotype and the antibody-dependent cellular cytotoxicity (ADCC) using lymphocytes from normal subjects. The cell surface phenotype, as evaluated by 2 monoclonal antibodies, was not affected whereas ADCC, at any of the doses used, was significantly reduced compared to the baseline value. The implications of these results for the use of indium 111 oxine for the in vivo studies are discussed.

Topics: Adult; Antibodies, Monoclonal; Antibody-Dependent Cell Cytotoxicity; Cell Survival; Female; Humans; Hydroxyquinolines; Immunosuppressive Agents; Indium; Lymphocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Phenotype; Radioisotopes

The trapping of 111Indium-oxine labelled autologous platelets by the transplant was recorded by means of a computerised gamma camera and expressed as platelet uptake index (PUI). Eighty-five patients were studied. The PUI increased in acute rejection from 1.13 +/- 0.11 to 1.74 +/- 0.17, and decreased again when rejection was reversed. In chronic rejection PUI was significantly lower than in acute rejection, but still higher than in long term stable grafts. Prostacyclin infusions were given to six cases of acute rejection and 12 of chronic rejection. In the majority of patients an improvement in transplant function and a decrease in platelet trapping could be demonstrated.

Topics: Adolescent; Adult; Blood Platelets; Child; Epoprostenol; Female; Graft Rejection; Humans; Hydroxyquinolines; Indium; Kidney; Kidney Transplantation; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Prostaglandins; Radioisotopes; Radionuclide Imaging

Indium-111 labelled autologous leucocyte imaging was used to assess severity in 13 patients with acute pancreatitis. All three patients with severe disease as judged by a prognostic factor grading system had a positive result on imaging. A fourth patient with mild disease as judged by prognostic factors had a positive imaging result and 14 days later developed a pseudocyst. There were no false positive or false negative scans. Evidence from three patients suggested that a positive 111In-leucocyte imaging result implies substantial fat necrosis. In this study imaging was as accurate as prognostic factor grading. The technique may be a useful method of separating mild from severe acute pancreatitis.

Topics: Acute Disease; Adult; Aged; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pancreatitis; Prognosis; Prospective Studies; Radioisotopes; Radionuclide Imaging; Ultrasonography

Several different methods for labelling autologous platelets with 111In-oxine have been described. However, no comparative study has been reported. In the present investigation two different labelling methods were compared in terms of labelling efficiency and platelet function in five species: human, dog, pig, rabbit and rat. One of the labelling methods, utilising among other things a serum albumin gradient separation of platelets and incubation of 111In-oxine in a water bath at 37 degrees C, was superior in all species with significantly higher labelling efficiency and unchanged platelet function.

Topics: Animals; Blood Platelets; Centrifugation, Density Gradient; Dogs; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Organometallic Compounds; Oxyquinoline; Platelet Aggregation; Rabbits; Radioisotopes; Rats; Rats, Inbred Strains; Swine

Topics: Humans; Hydroxyquinolines; Indium; Infections; Leukocytes; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

Topics: Abdomen; Abscess; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Retrospective Studies; Ultrasonography

The effect of acetaminophen on the labeling efficiency of leukocytes with indium oxine In 111 was studied. A blood sample was obtained from eight healthy men before and after they received acetaminophen 650 mg every four hours for 24 hours. After dividing the plasma from each sample into three portions, leukocytes were separated and labeled with indium oxine In 111. In an in vitro study, 200 ml of blood was obtained from one of the men, and the plasma was separated into four portions. Acetaminophen in 95% ethanol was added to three of the plasma fractions to produce acetaminophen concentrations of 4, 20, and 100 micrograms/ml; ethanol was added to the fourth fraction as a control. Each plasma fraction was then subdivided into three aliquots, and leukocytes were labeled as in the in vivo study. Mean leukocyte labeling efficiencies in both studies were calculated from the ratios of leukocyte radioactivity to initial radioactivity in the samples, expressed as percentages. Leukocyte labeling efficiencies before acetaminophen administration ranged from 79 to 85%; after administration, labeling efficiencies ranged from 70 to 87%. No significant differences in mean labeling efficiency before and after acetaminophen administration were noted in any of the subjects. Leukocyte labeling efficiencies in all in vitro plasma fractions were reduced, ranging from 54 to 63%, but no significant differences in labeling efficiency between any of the plasma fractions were found. Using the labeling procedures in this study, exposure of leukocytes from healthy men to acetaminophen in vivo or in vitro does not affect labeling efficiency with indium oxine In 111.

Topics: Acetaminophen; Adult; Humans; Hydroxyquinolines; In Vitro Techniques; Indium; Isotope Labeling; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Radioisotopes

Acute osteomyelitis was induced in 18 rabbits after direct injection of a solution of Staphylococcus aureus culture into a proximal tibial metaphysis. Serial plain radiographs and radionuclide studies with indium-111 oxide labeled while blood cells and technetium-99m methylene diphosphonate were performed over the next 4 weeks. Visual and quantitative analysis by measuring the isotope activity of 111In and 99mTc over the infected tibias as compared with the opposite bones revealed that the white blood cell scans were positive in 15 (83%) of the 18 rabbits during the first week after injection of the microorganism. During the same period, the 99mTc bone scans were positive in only 22% of the animals (p less than 0.005). In the animals that survived, both white blood cell and bone scans were positive during the second week, and thereafter, the bone scans revealed consistently higher activity than was observed with white blood cell scans. Computed tomography performed in six rabbits revealed an increased attenuation coefficient of the medullary cavities in the infected bones of four animals during the first week and of one more during the second week. Plain radiographs became positive after the 12th day. Results indicate that in patients with suspected acute osteomyelitis, white blood cell scans and probably computed tomography can detect the disease earlier than 99mTc bone scans and plain radiographs.

Topics: Animals; Diphosphonates; Hindlimb; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Rabbits; Radionuclide Imaging; Staphylococcus aureus; Technetium; Technetium Tc 99m Medronate; Time Factors; Tomography, X-Ray Computed

Topics: Animals; Blood Platelets; Humans; Hydroxyquinolines; Indium; Organometallic Compounds; Oxyquinoline; Papio; Rabbits; Radioisotopes

Topics: Albumins; Blood Platelets; Centrifugation, Density Gradient; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Organometallic Compounds; Oxyquinoline; Radioisotopes

Topics: Aged; Diagnosis, Differential; Humans; Hydroxyquinolines; Indium; Inflammation; Ketones; Leukocytes; Organometallic Compounds; Oxyquinoline; Pentanones; Radioisotopes; Radionuclide Imaging

Thirteen patients were investigated on 22 occasions at times varying from 1 day to 10 years after living family donor or cadaver renal transplantation. Platelet survival in the circulation, and in vivo platelet distribution and sites of deposition and sequestration was quantitatively determined with Indium-111-oxine (In-111-oxine) labelled platelets and a scintillation camera interfaced with a computer assisted imaging system. In all patients platelet survival was shortened and the platelet survival curve exponential. In patients with no evidence of transplant rejection and those with chronic rejection, there was no measurable or visible accumulation of labelled platelets in the kidney. The sequestration pattern of In-111 labelled platelets at the end of platelet life span was within normal limits and located in the reticuloendothelial system. In those patients with acute transplant rejection, platelet survival was shortened. Labelled platelets accumulated in the kidney: this was clearly visualized on scintigraphy and reflected by a significant increase in the radioactivity count density of the kidney. Platelets not deposited in the transplant were sequestrated in the reticuloendothelial system. This study demonstrates the diagnostic value of In-111 labelled platelet kinetics in the investigation of acute renal failure after renal transplantation. This investigation appears of limited clinical value in chronic rejection.

Topics: Adult; Blood Platelets; Cell Survival; Child; Female; Graft Rejection; Humans; Hydroxyquinolines; Indium; Kidney Transplantation; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes

Topics: Adolescent; Adult; Aged; B-Lymphocytes; Humans; Hydroxyquinolines; Indium; Kinetics; Leukemia, Lymphoid; Lymphocytes; Lymphoma; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; T-Lymphocytes; Tissue Distribution