indium-oxine and Chronic-Disease

Patients with chronic aortic dissection require monitoring for indications of disease progression. In present study, inflammation adjacent to associated aortic wall was evaluated by indium-111-oxine-labeled leukocyte scintigraphy, scince inflammation of the blood vessel wall often associates with progression of chronic aortic dissection.. Fifteen patients with aortic dissection underwent indium-111-oxine-labeled leukocyte scintigraphy. Seven showed positive images at sites corresponding to the actual sites of the dissociated aorta. Four patients with positive images underwent surgery. Histologic examination revealed inflammatory and necrotic changes of the aortic wall. During a mean follow-up period of 2.3 years, progression of aortic dissection was observed in two of the seven patients with positive intimal imaging.. Indium-111-oxine-labeled leukocyte scintigraphy may be a useful noninvasive technique to assess the persistent inflammation in patients with chronic aortic dissection.

Topics: Adult; Aged; Aorta, Thoracic; Aortic Aneurysm, Abdominal; Aortic Dissection; Chronic Disease; Disease Progression; Female; Follow-Up Studies; Humans; Leukocyte Count; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Tomography, X-Ray Computed; Vasculitis, Central Nervous System

When infection of implants is suspected, optimal management requires accurate confirmation or exclusion of infection. However, in spite of demonstrative clinical signs cultures of smears or chemical parameters of inflammation frequently are ambiguous. Scintigraphy with indium-labeled white blood cells (WBC) has been reported to be sensitive and specific in the diagnosis of low-grade sepsis of the musculoskeletal system. Twenty-eight patients with possible infection were prospectively studied. Infection was suspected in 19 cases with total hip joint prosthesis, 14 cases with knee joint prosthesis and 1 case with shoulder joint prosthesis. All of them underwent scanning with indium-111-labeled WBC and subsequently underwent surgery. At surgery infections were determined by means of culture or histologic results. When correlated with culture and histologic results sensitivity of 111-indium-WBC imaging was 89% with a specificity of 67% and a predictive accuracy of 77%. In patients with rheumatoid arthritis, however, predictive accuracy of 111-indium-labeled WBC imaging was higher than with standard diagnostic methods. The difference was statistically significant (P < 0.05, chi(2)-test). In the patients examined as a whole, predictive accuracy of 111-indium-labeled WBC imaging does not differ from that of standard diagnostic methods. That is why expensive and time-consuming 111-indium-WBC imaging is not justified generally in diagnosis of infection of implants. 111-Indium-WBC imaging is well suited to supplement standard diagnostic methods in patients with rheumatoid arthritis.

Topics: Adult; Aged; Arthritis; Chronic Disease; False Negative Reactions; False Positive Reactions; Hip Prosthesis; Humans; Indium Radioisotopes; Joint Prosthesis; Knee Prosthesis; Leukocytes; Middle Aged; Organometallic Compounds; Oxyquinoline; Prosthesis-Related Infections; Radionuclide Imaging; Sensitivity and Specificity; Shoulder Joint

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

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

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