indium-oxine and Focal-Infection

Indium-111 oxine labelled leucocyte (111In oxine leucocyte) scintigraphy is the test of choice in detecting occult infection and localising focal inflammation. 111In oxine labelling is technically difficult and expensive and leucocyte labelling with technetium-99m stannous colloid (99mTc Sn colloid) has been considered to be an alternative. Leucocytes from 40 cases referred for investigation of occult infection or localisation of inflammation were simultaneously labelled with 111In oxine and 99mTc Sn colloid with dual isotope acquisition performed at 1, 3 and 24 h. Twenty-four hour 99mTc Sn colloid scans were corrected for 111In downscatter. Each case was independently interpreted by two experienced observers. Twenty-one patients demonstrated positive 111In oxine leucocyte scans. Using 111In oxine leucocyte scans as the gold standard, 99mTc Sn colloid leucocyte scanning had an overall sensitivity of 86% and a specificity of 95%. Clinical follow-up verified that three patients had false negative 99mTc Sn colloid leucocyte scans and one patient had a false positive. Further clinical evaluation of 99mTc Sn colloid labelled leucocytes is required before they can become a reliable replacement for 111In oxine leucocytes.

Topics: Colloids; Evaluation Studies as Topic; Female; Focal Infection; Humans; Indium Radioisotopes; Inflammation; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Predictive Value of Tests; Radionuclide Imaging; Sensitivity and Specificity; Technetium; Technetium Compounds; Time Factors; Tin; Tin Compounds

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

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