sodium-pertechnetate-tc-99m and Osteomyelitis

The purpose of this study was to evaluate the diagnostic value of dual isotope bone-granulocyte scintigraphy in patients with known bone pathology clinically suspected of osteomyelitis, i.e. complicating osteomyelitis, using per-operative bacterial culture from bone as reference.. Simultaneous dual isotope bone-granulocyte scintigraphic images were obtained in 42 consecutive patients in whom conventional X-ray, erythrocyte sedimentation rate, and C-reactive protein were also available. 99mTc MDP bone and 111In labelled granulocyte imaging was obtained simultaneously. The images were interpreted as positive for osteomyelitis if regions of interests of pathologic 111In granulocyte accumulation included 99mTc MDP activity on the bone images (except in the spine).. The sensitivity, specificity, and accuracy were 84, 71 and 79%, respectively, for simultaneous, dual isotope bone-granulocyte scintigraphy, higher than the other diagnostic parameters.. Simultaneous bone-granulocyte scintigraphy is a valuable diagnostic tool in diagnosing osteomyelitis complicating other bone pathology with or without soft-tissue infection.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Blood Sedimentation; C-Reactive Protein; Diagnosis, Differential; Female; Granulocytes; Humans; Indium Radioisotopes; Male; Middle Aged; Osteomyelitis; Predictive Value of Tests; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m

Inflammatory lesions in 7 patients have been investigated using labelled in vivo granulocytes. Targeting of white cells was done with a monoclonal antibody, mouse IgG1 reacting with NCA (non-specific crossreacting antigen) and CEA (carcinoembryonic antigen) (BW 250/183) labelled with 99mTc. All inflammatory lesions were visualized, with excellent quality scintigram, between 3-6 and 24 h after the injection. Because the antibody can be stored in a freeze-dried form and labelled at any time with 99mTc without cell separation being necessary, the method appears to be suitable even for use in acute diagnosis.

Topics: Antibodies, Monoclonal; Arthritis, Infectious; Granulocytes; Humans; Osteomyelitis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Antigranulocyte immunoscintigraphy with a technetium-99m- (99mTc) labeled monoclonal antigranulocyte antibody (MAb BW 250/183) was performed in 34 in-patients of the departments of accident surgery and internal medicine in order to prove or exclude inflammatory processes. After labeling with 99mTc, 555 MBq, 99mTc-MAb (0.5 mg antibody) were slowly injected intravenously over a period of 5 min. A whole-body scan was done 4-6 hr postinjection, and planar or SPECT images were performed 6, 18, and 24 hr postinjection. Leukocyte immunoscintigraphy proved inflammatory suppurating processes in 20 cases (true-positive) and excluded them in 11 cases (true-negative). The findings were false-positive in two patients (hematoma without signs of infection, pseudoarthrosis) and false-negative in one patient (encapsulated lung abscess with pleural fibrosis). Anti-idiotypic human anti-mouse antibodies (HAMA) were found only in one out of 20 patients. According to our experiences, immunoscintigraphy with 99mTc-MAb BW 250/183 has a sensitivity of 95%, and is, therefore, well suited for the identification of leukocytic inflammations.

Topics: Abscess; Antibodies, Monoclonal; Humans; Leukocytes; Neutrophils; Osteomyelitis; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed, Single-Photon

Topics: Animals; Blood Platelets; Cattle; Cell Survival; Escherichia coli Infections; Humans; Indium Radioisotopes; Isotope Labeling; Lipids; Mice; Organometallic Compounds; Organotechnetium Compounds; Osteomyelitis; Oximes; Pyridines; Rabbits; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Solubility; Technetium Tc 99m Exametazime; Thiones; Tissue Distribution; Tropolone

The lipophilic 99mTc-DPO complex, developed as a myocardial imaging radiopharmaceutical, was used to label leucocytes. After an incubation of 0.1 ml 99mTc-DPO (8 micrograms DMPE*2HCl) with mixed leucocytes in plasma, the labelling efficiency was over 70%. During incubation in 5 ml plasma, a loss of activity was found between 20% (1 h) and 35% (3 h) caused by elution. Disturbances of cell viability could not be found with the help of the chemiluminescence test. The in vivo recovery was determined in three dogs and was 45%-50% (0.5 h), 30%-36% (1 h), and 18%-24% (3 h). Autologous 99mTc-DPO-leucocytes were used on seven patients with suspected osteomyelitis, there were four true negative and three true positive results. The target/nontarget ratio determined by ROI in the positive cases was 1.8 to 2.5 at 3 h after injection.

Topics: Bone and Bones; Heart; Humans; Leukocytes; Liver; Mannitol; Organometallic Compounds; Organotechnetium Compounds; Osteomyelitis; Oxalates; Phosphines; Predictive Value of Tests; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spleen; Technetium

Radionuclide joint imaging with the technetium-99m-labeled phosphates is a sensitive technique for the detection of inflammatory articular disease, although it is nonspecific as to the cause of the increased uptake and offers poor resolution in comparison to conventional radiography. There does not appear to be any place for the routine use of joint imaging of the peripheral joints, as there is little evidence that it benefits patient management. Scintigraphy is of benefit in the detection of osteomyelitis, Legg-Perthes' disease, and osteonecrosis, where changes may antedate roentgenologic abnormalities. Technetium-99m-phosphates may have an increasing role in the evaluation of knee and hip prosthetic joint loosening and infection, especially regarding the femoral components. Scintigraphy may be useful in excluding synovitis and allaying concern in selected patients with chronic articular pain in whom a conventional diagnostic evaluation is unrewarding. Attempts have been made to use radionuclide joint imaging to quantitate the degree of synovitis present in individual joints, particularly the sacroiliac joints. To date, reliable methods that distinguish normal from abnormal joints have not been established, although this remains an area of potential usefulness and active research. Scintigraphy with 99mTc-phosphates is useful in the detection of spinal fracture and pseudoarthrosis in individuals with ankylosing spondylitis.

Topics: Adult; Arthritis; Bone Neoplasms; Child; Diphosphates; Diphosphonates; Female; Gallium Radioisotopes; Humans; Joint Diseases; Legg-Calve-Perthes Disease; Male; Middle Aged; Osteoarthritis; Osteomyelitis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spondylitis, Ankylosing; Synovitis; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate