technetium-tc-99m-sulfur-colloid and indium-oxine

The use of neutrophils labeled with gamma-emitting radionuclides has been shown to be acceptable for in vivo kinetic studies as well as for imaging inflammatory foci. Among the gamma-emitting radionuclides, indium-111 appears to be the agent of choice. Labeling neutrophils with 111In, however, is a relatively new technique. Although simple to perform, it involves several stages, none of which could be carried out without problems. These are discussed and the current research aimed at eliminating the problems is outlined. The knowledge of specific chemotactic receptors and surface antigens has stimulated investigations into selective neutrophil labeling that will continue to be challenging and exciting.

Topics: Animals; Cell Separation; Chromium Radioisotopes; Dogs; Gallium Radioisotopes; Humans; Indium; Isotope Labeling; N-Formylmethionine Leucyl-Phenylalanine; Neutrophils; Organometallic Compounds; Oxyquinoline; Phosphorus Radioisotopes; Pyridines; Quality Control; Radiation Dosage; Radioisotopes; Selenomethionine; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Thiones

Persistent fever in a 60-yr-old man with polycystic kidney and liver diseases and bilateral hip prostheses was presented in this study. Multiple diagnostic tests failed to localize a source of infection. Subsequently, a combination of a 111In-oxine labeled WBC and 99mTc-sulfur colloid scans (and computer subtraction) demonstrated abnormally increased WBC activity in the left lobe of the liver, thus, diagnosis of an infected cyst (or cysts) was made. The patient responded to the treatment with antibiotics. This article discusses the clinical features of polycystic disease of the liver and kidneys. Infection in cysts are discussed as well as radiographic and scintigraphic investigations that can be used to diagnose and localize infection in a cyst.

Topics: Cysts; Fever; Hip Prosthesis; Humans; Indium Radioisotopes; Infections; Leukocytes; Liver Diseases; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Polycystic Kidney, Autosomal Dominant; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Several chelates are available for leukocyte labeling. Studies indicate that cells labeled with any of the chelates have a sensitivity for infection of 90% to 95% when imaged at 24 hours postinjection. The sensitivity of 111In-labeled leukocytes at earlier imaging times is more controversial. There has been concern about the utility of labeled leukocytes in musculoskeletal infection. Recent leukocyte studies show a high sensitivity for infected prostheses, even though these infections are often walled off and do not cause systemic symptoms. However, leukocytes frequently miss osteomyelitis of the spine for reasons that are not known. Although some investigators do not recommend the use of 111In-labeled leukocytes in chronic infections, we have found a high sensitivity for infections that are 2 or more weeks old. Autopsy studies from the preantibiotic era indicate that bacterial infections with common organisms have high levels of neutrophil infiltration for months. Labeled lymphocytes from mixed-cell preparations also may play a role in detecting these inflammatory sites. Questions have been raised about the effect of antibiotic therapy on leukocyte sensitivity. Antibiotics do not appear to have a significant effect on scan sensitivity. By reducing the number of bacteria at an inflammatory site, antibiotics reduce the amount of chemotactic inhibitors. In addition, some antibiotics have been shown to directly stimulate leukocyte chemotaxis. Other factors that can theoretically reduce leukocyte function, including hemodialysis, hyperalimentation, hyperglycemia, and steroids, do not appear to reduce labeled leukocyte sensitivity for infection. The specificity of leukocyte uptake is reduced in the gastrointestinal tract and lungs. In these sites, uptake correlates with infection or the true cause of the patients' fever in only 10% to 50% of cases.

Topics: Chronic Disease; Digestive System; Humans; Indium Radioisotopes; Infections; Leukocytes; Lung; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Sulfur Colloid; Tropolone

A total of 20 patients with posttraumatic osteomyelitis were investigated with 99mTc- and 111In-labeled leukocytes. Their elevated accumulation in inflammatory zones were detected on scintigrams of 12 patients. Osteomyelitis in 11 of them was confirmed on the basis of routine clinico-laboratory investigations. This method is a highly specific test in the diagnosis of posttraumatic osteomyelitis and in the assessment of the efficacy of its therapy.

Topics: Adult; Aged; Female; Humans; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Time Factors

Neutrophils isolated from human blood were labeled by various methods and exposed to a chemotactic gradient. The chemotactically functional cells that migrated into the gradient were isolated. The portion of radioactivity of the original cell suspension carried with the chemotactically responsive cells was related to the relative number of migrating cells as determined microscopically. Of the radionuclides used, P-32 diisopropylfluorophosphate (DFP), In-111 oxine, and Tc-99m sulfur colloid provided cell preparations with the highest relative portion of radioactivity confined to functionally intact (chemotactic) neutrophils. Results with Na2(51)CrO4 and with SnCl2-reduced 99mTcO4- were less than optimal. Neutrophils exposed to Ga-67 citrate apparently took up the label and retained chemotactic responsiveness. However, little or no radioactivity was detected in the neutrophils that migrated from the suspensions of Ga-67-labeled cells. The results indicate that the chemotaxis radioassay can yield unique information pertaining to the extent to which a radiotracer is specifically associated with viable neutrophils in a suspension of labeled cells.

Topics: Chemotaxis, Leukocyte; Chromates; Chromium Radioisotopes; Gallium Radioisotopes; Humans; Indium; Isoflurophate; Isotope Labeling; Neutrophils; Organometallic Compounds; Oxyquinoline; Phosphorus Radioisotopes; Radioisotopes; Sodium Compounds; Sodium Pertechnetate Tc 99m; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid