indium-oxine and Thrombophlebitis

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

Topics: Aged; Aortic Aneurysm; Blood Platelets; Blood Vessel Prosthesis; Cell Survival; Cerebrovascular Disorders; Heart Diseases; Humans; Indium; Ischemic Attack, Transient; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pulmonary Embolism; Radioisotopes; Radionuclide Imaging; Thrombocytopenia; Thromboembolism; Thrombophlebitis; Time Factors

Indium-111 platelet scintigraphy accurately detects acute deep venous thrombosis in asymptomatic high-risk patients and may be used as a surveillance test. However, its value in symptomatic patients and its accuracy early after platelet injection are not satisfactorily established. The latter is important for timely institution of therapy. Accordingly, 65 patients (67 limbs) with suspected deep venous thrombosis (symptom duration 8 +/- 10 days, mean +/- standard deviation) were prospectively studied with platelet scintigraphy and contrast venography. Platelets were labeled with 405 +/- 101 mCi indium-111 oxine. The labeling efficiency was 80 +/- 10%. All images were acquired within 120 minutes after intravenous administration of the platelet suspension. Both platelet scintigraphy and venography were interpreted independently by 2 blinded observers (for each technique). Five separate analyses were performed. Each scintigraphic reader was compared to each venographic reader. A fifth analysis--consisting of readings with blinded agreement of both readings of the platelet scans and both readings of the venograms--was performed. Interobserver agreement was 92% for venography and 79% for scintigraphy. Excluding anticoagulated patients, the sensitivity of platelet scintigraphy was between 38 and 46% and the specificity was between 92 and 100%. Thus, early imaging of labeled platelets for the diagnosis of symptomatic deep venous thrombosis carries a high specificity but a much lower sensitivity. It is speculated that the low sensitivity is related to the inactivity of the thrombus. This may suggest that early imaging will only be useful in patients whose symptoms are of recent onset.

Topics: Blood Platelets; False Negative Reactions; False Positive Reactions; Female; Humans; Indium Radioisotopes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Phlebography; Prospective Studies; Radionuclide Imaging; Thrombophlebitis; Time Factors

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

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

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

Topics: Humans; Indium; Organometallic Compounds; Oxyquinoline; Platelet Factor 4; Radioimmunoassay; Radionuclide Imaging; Serum Albumin; Technetium; Technetium Tc 99m Aggregated Albumin; Thrombophlebitis