technetium-tc-99m-exametazime and Abscess

To demonstrate the combined use of scintigraphy and ultrasonography (US) in differentiating osteomyelitis from bone infarction in sickle cell disease.. Two patients with sickle cell disease were examined with a combination of bone, bone marrow, white blood cell and/or gallium scintigraphy and US.. The scintigraphic studies demonstrated areas of suspected osteomyelitis at the distal femur in both patients and at the proximal right tibia in one of them. US revealed subperiosteal fluid collections in these areas. Aspiration guided by US established the presence of pus at the femur in both instances, which was successfully treated with the US-guided insertion of a drainage catheter and aspiration only, respectively. Thick blood, due to bone infarction, was aspirated at the tibia.. The scintigraphic studies were useful in locating all areas of suspected osteomyelitis. The role of US was to confirm the presence of a subperiosteal fluid collection and to guide aspiration, which can show the distinction between a haematoma and an abscess.

Topics: Abscess; Adult; Anemia, Sickle Cell; Bone and Bones; Bone Marrow; Child; Diagnosis, Differential; Female; Gallium Radioisotopes; Hematoma; Humans; Infarction; Male; Organotechnetium Compounds; Osteomyelitis; Oximes; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Technetium Tc 99m Medronate; Ultrasonography

Topics: Abscess; Diagnosis, Differential; Granulocytes; Humans; Indium Radioisotopes; Inflammatory Bowel Diseases; Intestinal Fistula; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime

Topics: Abscess; Aged; Aneurysm, False; Coronary Vessels; Humans; Leukocytes; Male; Prosthesis Failure; Stents; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Abscess; Coronary Artery Bypass; Diagnosis, Differential; Humans; Leukocytes; Male; Middle Aged; Osteomyelitis; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Staphylococcal Infections; Sternum; Surgical Wound Infection; Technetium Tc 99m Exametazime

Radiolabeled autologous leukocytes are the gold standard for imaging infectious foci in patients. Good results have also been reported for radiolabeled heterologous leukocytes from noninfected donors. Until now, the 2 methods have not been directly compared. In this study, we compared the infection-imaging potential of 99mTc-hexamethylpropyleneamine oxime (HMPAO)-labeled autologous granulocytes with that of 99mTc-HMPAO-labeled granulocytes from either infected or noninfected donors in rabbits with Escherichia coli infection.. The radiolabeled granulocyte preparations were studied in rabbits with an E. coli infection in the left calf muscle. The soft-tissue infections were scintigraphically visualized after injection of 18 MBq of either 99mTc-HMPAO purified autologous granulocytes or radiolabeled purified heterologous granulocytes from infected or noninfected donor rabbits. Gamma camera images were acquired at 2 min and at 1, 2, and 4 h after injection. After the last image, the rabbits were killed and uptake of the radiolabel in the dissected tissues was determined.. The 99mTc-HMPAO autologous granulocytes and heterologous granulocytes from infected donors accurately revealed the infectious focus in the calf muscle at 2 h after injection. At 4 h after injection, a significantly better (P < 0.05) delineation of the infection was established with the 99mTc-HMPAO autologous granulocytes and 99mTc-HMPAO heterologous granulocytes from the infected rabbits than with the heterologous granulocytes from noninfected donors. With both cell preparations, the intensity of uptake in the infected calf muscle continuously increased until 4 h after injection. The 99mTc-HMPAO heterologous granulocytes from noninfected donors showed no significant increase in contrast after 2 h after injection. Absolute uptake in the infected calf muscle was much higher for 99mTc-HMPAO autologous granulocytes (7.81 +/- 1.21 percentage injected dose [%ID]) and 99mTc-HMPAO heterologous infected granulocytes (8.91 +/- 1.92 %ID) than for the radiolabeled heterologous noninfected granulocytes (2.32 +/- 0.75 %ID) (P < 0.04) at 4 h after injection. The ratio of infected muscle to noninfected contralateral muscle was significantly higher for 99mTc-HMPAO autologous granulocytes and 99mTc-HMPAO heterologous granulocytes from infected donors than for 99mTc-HMPAO heterologous granulocytes from noninfected donors (5.53 +/- 1.09, 3.86 +/- 0.75, and 1.86 +/- 0.31, respectively; P < 0.05).. For nuclear medicine imaging of infection, purified granulocytes derived from infected rabbits are superior to purified granulocytes derived from noninfected donor rabbits. In addition, autologous granulocytes gave similar results to heterologous granulocytes from infected donor rabbits, suggesting the need for intrinsic cell activation for specific granulocyte migration.

Topics: Abscess; Animals; Escherichia coli Infections; Female; Granulocytes; Hindlimb; Leukocytes; Rabbits; Radionuclide Imaging; Technetium Tc 99m Exametazime; Time Factors; Tissue Distribution; Transplantation, Autologous; Transplantation, Heterologous

Topics: Abscess; Aged; Aged, 80 and over; Humans; Intervertebral Disc Displacement; Leukocytes; Male; Middle Aged; Osteomyelitis; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Exametazime; Technetium Tc 99m Medronate; Thoracic Vertebrae

In this study a new 99mTc labeling method for polyethyleneglycol (PEG)-coated liposomes is described. The in vitro and in vivo characteristics were compared with the conventional 99mTc-HMPAO-labeled PEG-coated liposomes.. PEG-coated liposomes were labeled with 99mTc by the hydrazino nicotinyl (HYNIC) derivative of distearoylphosphatidyl-ethanolamine (DSPE) and compared with PEG-coated liposomes labeled with 99mTc-HMPAO. In vitro stability tests were performed. Biodistribution and imaging characteristics of both liposomal preparations were determined in rats with Staphylococcus aureus infection in the left calf muscle.. Per liposome, 230 hydrazine groups were incorporated. The labeling efficiency of the 99mTc-HYNIC liposomes was greater than 95%, so no postlabeling purification was required, in contrast to the 99mTc-HMPAO liposomes. The 99mTc-HYNIC liposomes showed greater in vitro stability than the conventional 99mTc-HMPAO liposomes. Abscess uptake of the 99mTc-HYNIC liposomes was significantly greater (1.74+/-0.38%ID/g versus 1.26+/-0.29%ID/g, 24 h postinjection, P < 0.03). Furthermore, kidney uptake of the 99mTc-HYNIC liposomes was one third of the uptake of the 99mTc-HMPAO liposomes (0.79+/-0.07%ID/g versus 2.47+/-0.35%ID/g, 24 h postinjection, P < 0.0001).. This new 99mTc-HYNIC-based labeling method for liposomes is rapid, efficient and easy to perform. Most importantly, the 99mTc-labeled liposomes have an improved stability and in vivo characteristics. The new labeling method is a major step forward toward a radiopharmaceutical for infection imaging that can be prepared in a one-step procedure within 15 min at room temperature and thus can be applied in every routine clinical practice.

Topics: Abscess; Animals; Drug Carriers; Gamma Cameras; Hindlimb; Hydrazines; Liposomes; Male; Niacinamide; Phosphatidylethanolamines; Polyethylene Glycols; Radionuclide Imaging; Rats; Rats, Wistar; Staphylococcal Infections; Technetium; Technetium Tc 99m Exametazime; Tissue Distribution

Two abscesses were shown on CT in a 72-year-old man: one in the left hip and one in the left pelvic region that resulted from a motor vehicle collision that occurred 8 months earlier. Bone scintigraphy showed increased uptake in the left hip area. On Tc-99m HMPAO leukocyte imaging, the hip area appeared to be photopenic, and the abscess of the left pelvis was not identified. Incidental uptake in the left lung base appeared to be an active acute inflammatory process as evidenced by an infiltrating lesion in the left lower lung on a chest radiograph. Because leukocyte scintigraphy cannot detect the presence of a chronic inflammatory process in the absence of acute inflammatory cells, the patient's abscesses in the left hip and the left pelvis did not localize Tc-99m HMPAO-labeled neutrophils. The cold lesion in the left hip area was most likely caused by the lesion in the reticuloendothelial system (bone marrow); the unidentifiable pelvic lesion was related to the area(s) outside the reticuloendothelial system. In interpreting a labeled leukocyte image, clinicians should be alert to the stage (chronic or acute) and location (regardless of whether in the reticuloendothelial system) of infectious lesion(s). In this patient, a wide spectrum of manifestations was evident on leukocyte scintigraphy.

Topics: Abscess; Aged; Enterococcus faecalis; Gram-Positive Bacterial Infections; Hip; Humans; Inflammation; Leukocytes; Lung Diseases; Male; Neutrophils; Pelvis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, X-Ray Computed

Forty-nine patients (age > 50 years) with an acute abdomen and suspected appendicitis, but with atypical findings, were included in the study. After the intravenous injection of 99Tcm-hexamethylpropylene amine oxime (99Tcm-HMPAO) labelled white blood cells (WBCs), serial anterior images of the abdomen and pelvis were obtained after 30, 60, 120 and 240 min. Any abnormal localization of WBC accumulation in the right lower quadrant of the abdomen equal to or greater than bone marrow activity was considered positive. Twenty-five patients had positive WBC scans, all of whom underwent laparotomy. Twenty-three of these patients were shown to have appendicitis; the other 2 did not. The other 24 patients had a negative WBC scan, 2 of whom underwent laparotomy and were shown to have appendicitis; the other 22 patients did not undergo surgery and showed no evidence of appendicitis during follow-up. The overall sensitivity, specificity, accuracy, positive and negative predictive values of WBC scans for diagnosing appendicitis were as follows: 92.0%, 91.7%, 91.8%, 92.0% and 91.7% respectively. In conclusion, 99Tcm-HMPAO-labelled WBC scans provide a rapid and highly accurate method for diagnosing appendicitis in older patients with equivocal clinical findings.

Topics: Abdomen, Acute; Abscess; Acute Disease; Aged; Appendicitis; False Negative Reactions; False Positive Reactions; Female; Humans; Injections, Intravenous; Leukocytes; Male; Middle Aged; Organotechnetium Compounds; Oximes; Predictive Value of Tests; Technetium Tc 99m Exametazime; Tissue Distribution; Tomography, Emission-Computed

Topics: Abscess; Adult; Humans; Leg Ulcer; Leukocytes; Male; Necrosis; Opioid-Related Disorders; Radionuclide Imaging; Radiopharmaceuticals; Skin; Technetium Tc 99m Exametazime

The performance of 99mTc Stealth liposomes was investigated in various rat models.. Preformed polyethyleneglycol-containing liposomes with encapsulated reduced glutathione, were radiolabeled using the lipophilic 99mTc-HMPAO. The labeled liposomes were intravenously administered to rats with focal S. aureus or E. coli infection, or turpentine-induced inflammation. For comparison, Tc-99m-nanocolloid- and 99mTc-labeled nonspecific IgG were tested. In rats with Pneumocystis carinii pneumonia (PCP), Tc-99m-liposomes were directly compared to In-111 labeled nonspecific IgG.. Technetium-99m-liposomes accumulated in the infectious and inflammatory muscle foci over 24 hr (0.59% injected dose per gram tissue (%ID/g) for S. aureus; 1.18 %ID/g for turpentine). Abscess-to-muscle ratios increased to values as high as 24.0, 41.7 and 44.5 for the respective models at 24 hr postinjection. Technetium-99m-liposomes visualized the foci as early as 1 hr postinjection. Technetium-99m-IgG visualized S. aureus infection, but abscess-to-muscle ratios and abscess uptake at the later time points were significantly lower. Technetium-99m-nanocolloid failed to visualize any of the muscle foci. In PCP however, 99mTc-liposomes did not show preferential localization in the infection. The control agent 111In-IgG showed a significant, two-fold increase in lung uptake.. Technetium-99m-Stealth liposomes preferentially accumulated in abscesses, leading to very high target-to-nontarget ratios. This property appears to be related to a process based on uptake of long-circulating particles. In a specific type of infection, i.c. PCP, 99mTc-liposomes did not accumulate in diseased lung tissue, thus mimicking the in vivo behavior of labeled leukocytes.

Topics: Abscess; Animals; Escherichia coli Infections; Female; Immunoglobulin G; Indium Radioisotopes; Inflammation; Liposomes; Male; Organotechnetium Compounds; Oximes; Pneumonia, Pneumocystis; Radioimmunodetection; Rats; Rats, Sprague-Dawley; Rats, Wistar; Staphylococcal Infections; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Exametazime; Tissue Distribution

Topics: Abdomen; Abscess; Female; Humans; Kidney Failure, Chronic; Leukocytes; Middle Aged; Organotechnetium Compounds; Oximes; Peritoneal Dialysis, Continuous Ambulatory; Peritoneal Diseases; Peritonitis; Radionuclide Imaging; Technetium Tc 99m Exametazime

A new method for the labelling of mixed leucocytes with 99mTc-tropolone was optimized and compared with a 99mTc-HMPAO leucocyte labelling procedure in vitro and in vivo. In the present study, leucocytes obtained from patients suffering from Crohn's disease, were isolated and labelled with 99mTc-HMPAO or labelled according the new 99mTc-tropolone procedure using 9.8 mM tropolone, 1 microM stannous chloride and 0.8 mM potassium borohydride (KBH4) at pH 5.5-6. Labelling efficiency with 99mTc-tropolone yielded 92 +/- 3%, which is higher compared to the 99mTc-HMPAO labelling procedure (64 +/- 13%) using 10(8) of leucocytes. In vitro stability and viability of both the tropolone and the HMPAO labelled cells was investigated. The viability test of the 99mTc-labelled leucocytes was performed in autologous plasma at 37 degrees C and compared with unlabelled leucocytes. After 18 hours of incubation a significant (P < 0.05) higher stability was observed for 99mTc-tropolone labelled leucocytes (84 +/- 5%) compared with that of 99mTc-HMPAO labelled leucocytes (73 +/- 5%). The viability of the 99mTc-labelled leucocytes observed for both labelling procedures was similar to unlabelled leucocytes. In vivo experiments were performed in mice. 99mTc-tropolone or 99mTc-HMPAO labelled murine mixed leucocytes were injected in mice, with a Staphylococcus aureus ATCC 25923 thigh infection. Analysis of scintigraphic images yielded a faster clearance of the 99mTc-tropolone labelled leucocytes. This was most likely due to a significant (P < 0.02) higher liver uptake at 4 hours after administration of the 99mTc-tropolone labelled leucocytes (19%) in comparison with 99mTc-HMPAO labelled cells (9%). Faster and significant (P < 0.02) higher accumulation of the 99mTc-tropolone labelled leucocytes was observed at the site of infection compared with 99mTc-HMPAO labelled leucocytes at all time-intervals after the administration of the 99mTc-labelled leucocytes. The new 99mTc-tropolone leucocyte labelling procedure, offers an attractive low-cost agent for research purposes.

Topics: Abscess; Animals; Borohydrides; Cell Survival; Chromatography; Humans; Hydrogen-Ion Concentration; In Vitro Techniques; Isotope Labeling; Leukocytes; Male; Mice; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Staphylococcal Infections; Technetium Tc 99m Exametazime; Tin Compounds; Tropolone

Topics: Abscess; Granulocytes; Humans; Inflammatory Bowel Diseases; Intestinal Diseases; Intestinal Fistula; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime

Scintigraphy with autologous granulocytes labelled by technetium-99m hexamethyl, propylene amine oxime (99mTc-HMPAO) was performed in 103 Crohn's disease patients and 52 healthy controls. In 31 patients endoscopic and histologic activity was compared with scan activity index. In the 98 patients with a positive scan, the extent of Crohn's disease, assessed by scintigraphy, was compared with that evaluated by small bowel x ray or colonoscopy with biopsies. In 48 patients, Crohn's disease activity index, activity index, simple index, erythrocyte sedimentation rate, C-reactive protein were correlated with the scan results. In 16 patients the five parameters and scan were repeated after treatment with methyl-prednisolone (10 cases), enteral nutrition (3), and 5-acetylsalicylic acid (3). The results showed that 99mTc-HMPAO granulocyte scan had a 95% sensitivity and 100% specificity to detect active inflammation; it correctly showed an abscess or a fistula in all the 24 cases found. The correlation between histological inflammatory activity and scan activity index was highly significant (r = 0.85; p < 0.01), less significant (r = 0.65; p < 0.01) between endoscopy and scan activity index. The evaluation for the extent of Crohn's disease by scan was completely correct in the small bowel (100%) and 93% correct in the large bowel. No correlation was seen between the three clinical activity parameters and scanning; in more than 80% of the cases in remission on the basis of a clinical or laboratory index, scintigraphy remained positive. Medical treatment was effective on the clinical indices but not on the active inflammation in the ileum, whereas it led to a negative scan in 5/11 cases in the large intestine. Scintigraphy with 99mTc-HMPAO granulocyte plays an important part in Crohn's disease for the diagnosis of complications, for activity and assessment of the extent, and for the treatment results evaluation.

Topics: Abscess; Adolescent; Adult; Aged; Blood Sedimentation; C-Reactive Protein; Colonic Diseases; Crohn Disease; Female; Granulocytes; Humans; Ileal Diseases; Intestinal Fistula; Male; Middle Aged; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime

Thirty patients with clinically suspected infective endocarditis were scanned with Indium-111- or Tc-99m-HM-PAO-labeled granulocytes. The scans were correlated with the clinical course, and in 20 cases with the results from histologic examination of the valves. In six cases the scintigraphic examination gave correct positive results, in three cases false negative, in one case a false positive, and in 20 cases correct negative results. If we limit the analysis to only the histologically proven cases, our data suggest a specificity of the method of 86% and a sensitivity of about 67%.

Topics: Abscess; Echocardiography; Endocarditis, Bacterial; Granulocytes; Heart Valve Prosthesis; Heart Valves; Humans; Image Enhancement; Indium Radioisotopes; Leukocyte Count; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Sepsis; Technetium Tc 99m Exametazime

A simplified and efficient procedure for 99mTc-HMPAO-labelling of leukocytes is described. For this purpose, the pH and concentration of the 99mTc-HMPAO preparation was modified. Leukocytes were isolated from a 20 mL mixture of patient blood, 5 mL ACD and 0.8 mL methylcellulose after 1 h sedimentation of erythrocytes and centrifugation (at 400 g) of the obtained plasma layer. Simultaneously, 99mTc-HMPAO was prepared (one single-dose kit for two patients) by adding 2.2 mL 99mTc-generator eluate and, after 10 min, 0.3 mL of phosphate buffer to lower the pH to 7. The isolated WBCs were then labelled by the addition of 1-1.2 mL of 99mTc-HMPAO solution and incubated for 20 min. The unbound tracer was then discarded, the labelled WBC washed and finally resuspended in autologous cell-free plasma. Leukocytes labelled by this procedure were used for scintigraphic localization of inflammatory lesions and abscesses in the gastro-intestinal tract. The labelling efficiency was 60 +/- 9%, with a separation yield of 55 +/- 11%.

Topics: Abscess; Humans; Hydrogen-Ion Concentration; Inflammation; Leukocytes; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime; Time Factors

To assess the value of 99mTc-HMPAO-labelled-leucocyte scintigraphy in the detection of abdominal abscesses, the results of 74 examinations in 69 patients suspected of having abscesses on clinical grounds were reviewed retrospectively. Of a final total of 29 abscesses in 28 patients, leucocyte scanning diagnosed 26, giving a sensitivity, specificity, and accuracy of 90%, 91%, and 91%, respectively. In 22 patients abscesses were diagnosed within 30 min. In 13 of the 74 examinations (18%) an infection or inflammatory lesion other than an abscess was diagnosed. 99mTc-HMPAO-labelled-leucocyte scintigraphy is an accurate and rapid method of diagnosing abscesses in acutely ill patients.

Topics: Abdomen; Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Child; Female; Humans; Leukocytes; Male; Middle Aged; Organotechnetium Compounds; Oximes; Predictive Value of Tests; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Exametazime

The diagnostic value of early 99mTc-HMPAO-leukocyte images (2 min, 0.5 hr, 2 hr and 4 hr) was studied in 87 prospectively performed investigations in 80 patients with a suspicion of abdominal inflammation or infection. Sensitivity, specificity and accuracy were 74%, 85% and 77% in the 2-min scans, 88%, 81% and 86% in the 0.5-hr scans, 95%, 85% and 92% in the 2-hr scans, and 96%, 92% and 95% in the 4-hr scans. Nonspecific bowel accumulation was seen in 7% of patients at 2 hr and in 28% at 4 hr but was easily distinguishable from pathologic activity. The uptake in early images represents an active accumulation of granulocytes at the site of inflammation rather than nonspecific blood-pool activity judged by results of 99mTc-HMPAO-RBC imaging. We found that imaging within 2 hr from injection has a high diagnostic value, and that the activity accumulates in areas of infection and inflammation faster than in the intestinal background.

Topics: Abdomen; Abscess; Diverticulitis; Erythrocytes; Evaluation Studies as Topic; Female; Humans; Inflammatory Bowel Diseases; Leukocytes; Male; Middle Aged; Organotechnetium Compounds; Oximes; Predictive Value of Tests; Prospective Studies; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Exametazime; Time Factors

Topics: Abdomen; Abscess; Humans; Infections; Inflammation; Leukocytes; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime

One hundred patients with suspected acute abdominal inflammation were imaged at 0.5, 2-3, 4-6, and 24 hours after the administration of Tc-99m HMPAO labeled autologous leukocytes. Scan findings were retrospectively compared with final diagnosis, serum C-reactive protein (CRP), and antibiotic treatment. Clinical findings were confirmed with surgery, barium enema, or sigmoidoscopy in 61 patients, and diagnosis was based only on clinical findings in 13 patients. In 26 patients, symptoms subsided before a final diagnosis was made. Tc-99m leukocyte images were positive in 45 of the 61 patients with a confirmed diagnosis, including all patients with acute cholecystitis (N = 4) and inflammatory bowel disease (N = 8). They were also positive in nineteen out of 25 patients who had acute colonic diverticulitis and in 6 out of 7 who had intra-abdominal abscesses. Abnormal activity was found in patients with colonic carcinoma, small bowel infarction, and acute appendicitis. Abnormal activity was visualized in 0.5-hour images in all but one of the positive cases. With the exception of two postoperative cases, malignant lymphoma, and a liver abscess, a CRP level of greater than 75 mg/L was associated with positive image findings. Antibiotic treatment did not affect imaging findings. Imaging with Tc-99m labeled leukocytes appears to be valuable for detecting and localizing abdominal inflammation, and three-phase imaging during the first 4-6 hours is recommended. In some cases, 24-hour images may be useful for distinguishing small bowel from large bowel inflammation.

Topics: Abscess; Acute Disease; C-Reactive Protein; Cholecystitis; Diverticulitis, Colonic; Humans; Inflammatory Bowel Diseases; Leukocytes; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime; Time Factors

Labelling leucocytes with 99Tcm using hexamethylpropyleneamine oxime (HMPAO) utilizes the advantages of technetium over indium in imaging inflammation. A retrospective study has been performed on 43 consecutive patients imaged with 99Tcm HMPAO labelled leucocytes in order to assess the reliability of the technique. Particular attention was paid to the different handling characteristics of the 99Tcm HMPAO labelled cells compared with those labelled with indium. It was found that 99Tcm HMPAO labelled leucocytes gave an overall accuracy of 93.2%, a sensitivity of 92.8%, a specificity of 93.3% and a positive predictive value of 86%. 99Tcm HMPAO labelled leucocyte scanning provides a reliable method of imaging inflammation, though errors in interpretation may occur due to the hepato-biliary excretion of activity that occurs with this technique.

Topics: Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Crohn Disease; Humans; Inflammation; Leukocytes; Middle Aged; Organotechnetium Compounds; Osteomyelitis; Oximes; Pelvis; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Exametazime

Topics: Abdomen; Abscess; Adult; Humans; Leukocytes; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime; Time Factors

Topics: Abdomen; Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Arteriovenous Shunt, Surgical; Child; Evaluation Studies as Topic; False Negative Reactions; False Positive Reactions; Female; Fever of Unknown Origin; Humans; Infections; Male; Middle Aged; Organotechnetium Compounds; Osteitis; Oximes; Radionuclide Imaging; Surgical Wound Infection; Technetium Tc 99m Exametazime

Topics: Abscess; Colitis, Ulcerative; Crohn Disease; Granulocytes; Humans; Organometallic Compounds; Oximes; Oxyquinoline; Radionuclide Imaging; Technetium Tc 99m Exametazime

Forty-three patients with suspected benign, inflammatory, or infectious diseases were imaged with [99mTc]HM-PAO-labeled leukocytes and [67Ga]citrate. Technetium-99m leukocytes showed 22 true-positive, no false-positive, 19 true-negative, and two false-negative findings and [67Ga]citrate 23, 7, 12 and 1, respectively. The sensitivity, specificity, and accuracy values with 99mTc leukocytes were 92%, 100%, and 95%, and with [67Ga]citrate 96%, 63%, and 81%. Technetium-99m leukocyte scintigraphy has a promising future in comparison with [67Ga]citrate because of the ready availability of [99mTc]HM-PAO, the good image quality, more rapid results (within few hours), and the lower radiation exposure to the patient with 99mTc leukocytes. The usefulness of 99mTc leukocytes in chronic osteomyelitis needs further evaluation.

Topics: Abdomen; Abscess; Adult; Aged; Blood Vessel Prosthesis; Bone Neoplasms; Citrates; Citric Acid; Female; Hip Prosthesis; Humans; Ilium; Infections; Inflammation; Leukocytes; Lymphoma; Male; Middle Aged; Organometallic Compounds; Oximes; Radionuclide Imaging; Technetium; Technetium Tc 99m Exametazime

70 patients with confirmed (23 patients) or suspected (47 patients) bacterial infection in the skeleton following diseases, injuries or operations in orthopedic surgery were investigated using Tc-99m-HMPAO leucocyte scintigraphy in order to evaluate the accuracy of this procedure. Infections could be detected correctly in 37 of 70 patients (right positives) while 28 patients had negative scans corresponding to the clinical course (right negatives). One false negative finding was observed. Five patients with clinically suspected infection had a focal uptake in the WBC-scan and were not operated subsequently. They range as false positive results, although they belong to a special group (Infection: Yes-Operation: No [IYON]-group). In the assessment of the Tc-99m-HMPAO-WBC-scan there was a senstivity of 97.1%, specificity of 82.9% and an overall accuracy of 90%. The method is suitable for detection of early and late infection as well as chronic or hematogenous osteomyelitis in the locomotor system. This means an important contribution in diagnosis of infection determining further operative or conservative treatment.

Topics: Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Bacterial Infections; Child; Female; Follow-Up Studies; Fracture Fixation, Internal; Hip Prosthesis; Humans; Leukocytes; Male; Middle Aged; Organometallic Compounds; Osteomyelitis; Oximes; Radionuclide Imaging; Surgical Wound Infection; Technetium Tc 99m Exametazime

Topics: Abdomen; Abscess; Evaluation Studies as Topic; Granulocytes; Humans; Indium; Oximes; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Exametazime

99mTc-hexamethylpropylene amine oxime d,l diastereoisomer (HM-PAO), developed as a diffusible brain imaging agent, labels leukocyte suspensions in saline with an efficiency of 80% using 1-200 micrograms quantities. In dogs, the recovery and survival of reinjected cells in the bloodstream resemble those of 111In-oxine labeled cells at least for several hours. Images in control animals at 18 h show the spleen, liver, marrow, and bladder, minimal pulmonary activity and some gastrointestinal activity. Induced E. coli abscesses and joint inflammatory lesions in dogs are shown on 18 h images. This complex appears promising as an agent for abscess detection in humans. However, strict quality control of this agent is necessary, and it must be used immediately after the 99mTc complex is formed for labeling cells.

Topics: Abscess; Animals; Dogs; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Organometallic Compounds; Oximes; Oxyquinoline; Radionuclide Imaging; Technetium Tc 99m Exametazime; Tissue Distribution