chiniofon and Abscess

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

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

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

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

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

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

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

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

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

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

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

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 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

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

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

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

Bacterial abscesses were evoked in goats. Imaging of these abscesses was obtained by means of labelling autologous granulocytes with 111In oxinate, reinjection of the cells into the animal, and scintigraphy by gamma camera one day later. Comparable imaging results, however, were obtained after intravenous injection of 111In oxinate or of 111In chloride. The gamma camera images were supported by tissue distribution studies. In the case of administration of 111In oxinate to the goats, the radioactivity accumulated in the cell fraction of the blood to a significant extent. This did not occur in the case of plain 111In chloride. It remained unexplained why such different accumulation in cells did not result in differences in the scintigraphic studies. Blood clearance studies supplied conclusive evidence that the granulocytes stayed in the circulation for several days following labelling with 111In oxinate and reinjection of the cells into the animals.

Topics: Abscess; Animals; Bone and Bones; Chlorides; Female; Goats; Granulocytes; Hydroxyquinolines; Indium; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Time Factors; Tissue Distribution

A method is described for labeling autologous leukocytes with indium-111 oxine, which is used for localizing inflammatory processes. To an aqueous solution of indium-111 chloride was added sodium acetate buffer, pH 5.0, and then a freshly prepared solution of oxine (8-hydroxyquinoline) in ethanol. After 3-5 minutes of incubation at room temperature, the chelated indium-111 oxine was extracted with chloroform, evaporated to dryness, redissolved in ethanol, and diluted with 0.9% saline. Leukocytes were isolated from venous blood by centrifugation at 300-350 g and resuspended in 0.9% saline. The cells were labeled by adding the indium-111 oxine solution to the leukocyte suspension. Clinical results have shown indium-111-labeled leukocytes to be highly specific for abscess localization. Indium-111 is useful for imaging because its gamma emissions are suitable for external detection and its half-life of 67 hours allows studies to be performed over several days without presenting an excessive radiation dose to the patient.

Topics: Abscess; Blood Transfusion, Autologous; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Leukocyte Transfusion; Leukocytes; Oxyquinoline; Radioisotopes; Radionuclide Imaging

The biodistributions of In-111 oxine (with and without leukocyte labeling) of Ga-67 citrate and of In-111 chloride were compared in 30 dogs with chemical and bacterial abscesses and acute joint inflammation. Serial blood samples were taken and tissues radioassayed at 24 hr. The concentration of In-111-oxine leukocytes in all three types of inflammatory lesion was invariably much higher than that of Ga-67 injected simultaneously. For bacterial abscesses, the mean abscess-to-muscle concentration ratio was 3,000 for labeled leukocytes and 72 for Ga-67. Aqueous buffered In-111 oxine sulfate solution appeared better for labeling leukocytes than In-111 oxine in ethanol. When In-111 oxine was not incubated with leukocytes before injection, or if the cells were poorly labeled or damaged, the abscess localization was often inferior to that of gallium. Localization of In-111 chloride also appeared inferior to that of gallium. No significant difference in distribution in the major organs or inflammatory lesions was demonstrable between labeled suspensions of "pure"neutrophils harvested by elutriation and "mixed"cell suspensions of leukocytes after erythrocyte sedimentation with hydroxyethyl starch. For both types of leukocyte suspension labeled with In-111 oxine, the average recovery of cell-bound activity in the circulating blood at 4 hr was 32% of the administered activity, inferior to that of DFP-32. It is concluded, therefore, that In-111 oxine is a more effective agent than Ga-67 for the detection of acute focal inflammatory lesions if leukocytes are properly labeled, but current techniques are unsatisfactory for the study of neutrophil kinetics.

Topics: Abscess; Animals; Arthritis; Dogs; Female; Gallium Radioisotopes; Hydroxyquinolines; Indium; Inflammation; Isotope Labeling; Leukocytes; Male; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Tissue Distribution

Topics: Abscess; Animals; Blood Cells; Dogs; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Oxyquinoline; Rabbits; Radioisotopes; Radionuclide Imaging; Technetium; Thrombosis