Technetium-99m human immunoglobulin (HIG): a new substance for scintigraphic detection of bone and joint infections.
Technetium (99m-Tc)-labelled, polyclonal human immunoglobulin (HIG) has been described as a new agent to detect local infection and inflammation. In this study, we tested 99m-Tc HIG in 55 patients with suspected chronic (n = 42) and acute (n = 13) skeletal infection. Diagnosis was proven operatively (n = 44) and clinically (n = 11), including microbiological culture tests (n = 46). A gamma camera scan was performed 4 and 24 hours after I.v. injection of 500 MBq 99m-Tc-HIG. 99m-Tc-HIG scanning achieved a sensitivity of 91% and a specificity of 93%. We found one false negative and five false positive scintigraphic results in 55 patients. No clinical or biochemical side effects were encountered after 99m-Tc-HIG injection. We recommend this technique especially for localisation of low-grade, chronic osteomyelitis. The mechanisms and kinetics of 99m-Tc-HIG, however, are worth investigating more extensively.
Machens
H G
HG
Department of Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Germany.
Pallua
N
N
Becker
M
M
Mailaender
P
P
Schaller
E
E
Brenner
P
P
Bihl
H
H
Friedl
W
W
Berger
A
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007136:Immunoglobulins; D007592:Joint Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013667:Technetium
D007136:Immunoglobulins; C065376:technetium Tc 99m immunoglobulin; D013667:Technetium