sodium-pertechnetate-tc-99m and Infections

This study investigated radiolabeled bacteriophages for specific detection of infection through gamma imaging. Previously, a (99m)Tc-labeled M13 phage demonstrated specific binding for its host Escherichia coli in vitro and in mice through imaging.. This study was extended to phages P22, E79, VD-13 and phage 60. Each was radiolabeled with (99m)Tc using the chelator MAG(3), and were evaluated for binding to host and non-host bacteria in vitro and in a mouse infection model.. In vitro, each (99m)Tc-phage bound to its host at least 4-fold higher than to non-host bacteria. For example, (99m)Tc-E79 showed 10- to 20-fold greater binding to host Pseudomonas aeruginosa compared to non-host Escherichia coli and Salmonella enterica, and (99m)Tc-phage 60 showed 20-fold greater binding to host Klebsiella pneumoniae over non-hosts. Mice received host or non-host bacteria in one thigh, and 3 h later, the (99m)Tc-phages were administered intravenously. After a further 3 h, the tissues were counted. Liver accumulation was highest for (99m)Tc-E79, averaging 39% compared to an average of 13% for the other (99m)Tc-phages. Animals infected with host bacteria showed infected thigh/normal thigh ratios of 14.2 for (99m)Tc-E79, 2.9 for (99m)Tc-P22, 3.5 for (99m)Tc-VD-13 and 2.1 for (99m)Tc-phage 60.. Although specific host binding was observed in vitro for each of these four (99m)Tc-phages, only (99m)Tc-E79 showed specificity for its host in an in vivo model.

Topics: Animals; Bacteria; Bacterial Infections; Bacteriophages; Disease Models, Animal; Escherichia coli; Host-Pathogen Interactions; Infections; Isotope Labeling; Klebsiella pneumoniae; Male; Mice; Pseudomonas aeruginosa; Radionuclide Imaging; Radiopharmaceuticals; Salmonella enterica; Sodium Pertechnetate Tc 99m; Species Specificity; Tissue Distribution

The aim of our study was to evaluate the clinical value of immunoscintigraphy with the monoclonal antibody 99mTc-BW 250/183 in patients with fever of unknown origin (FUO). The antibody BW 250/183 is an immunoglobulin G1 subtype that binds to the antigen NCA-95, which is expressed on the cell membrane surface of granulocytes.. We studied 51 patients who were referred with the diagnosis of FUO. Thirty-five percent of the patients suffered from infection, 17% had autoimmune diseases, 14% had neoplasms and 8% had other diseases. The remaining 28% of the patients did not have a diagnosis. Planar imaging was performed in all patients, and 19 patients underwent SPECT. In our analysis, both cold and hot spots were considered diagnostic.. Pyogenic infections were visualized correctly in 13 foci. The diagnosis of endocarditis (n = 4) could be determined only by SPECT. False-negative results were found in 4 patients and false-positive uptake was seen in 2 patients. No false-positive uptake or cold spots in the central bone marrow were found in patients with viral, granulomatous and autoimmune diseases or in those patients in whom no FUO cause was found in a 6-mo follow-up. In these patients, a negative scan did not change their diagnostic work-up. Cold spots in the central bone marrow were correctly interpreted in 5 of 6 patients. Sensitivity in detecting pyogenic foci was 73% and specificity was 97%. Positive and negative predictive values were 93% and 87%, respectively. Including areas of decreased uptake in the analysis, sensitivity for detecting an underlying inflammatory or malignant process for FUO was 81 % and specificity was 87%. Positive and negative predictive values were 81% and 87%, respectively.. Immunoscintigraphy with 99mTc-BW 250/183 in patients with FUO has clinical potential for the diagnosis and exclusion of pyogenic causes of FUO. Metastatic malignant disease and high-grade spondylodiskitis could be diagnosed early in a diagnostic work-up by a characteristic cold spot pattern in the bone marrow. SPECT is indispensible for scintigraphic imaging of endocarditis.

Topics: Adult; Antibodies, Monoclonal; Autoimmune Diseases; Female; Fever of Unknown Origin; Humans; Infections; Leukocytes; Male; Neoplasms; Predictive Value of Tests; Radioimmunodetection; Radiopharmaceuticals; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed, Single-Photon

Topics: Humans; Infant; Infections; Male; Pulmonary Embolism; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Aggregated Albumin

Abdominal scanning using sodium pertechnetate Tc 99m is useful in demonstrating Meckel's diverticula containing ectopic gastric mucosa. However, other structures like the uterus may also concentrate 99mTc. We present a case which showed a focal area of increased uptake in the pelvis due to an infected ovarian cyst.

Topics: Adult; False Positive Reactions; Female; Humans; Infections; Meckel Diverticulum; Ovarian Cysts; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Topics: Central Nervous System Diseases; Critical Care; Dopamine; Hemodynamics; Humans; Infections; Liver Circulation; Portal Vein; Radionuclide Imaging; Sepsis; Sodium Pertechnetate Tc 99m; Splanchnic Circulation; Surgical Wound Infection; Technetium