title: Technetium-99m labeled to human immunoglobulin G through the nicotinyl hydrazine derivative: a clinical study.
abstract: A novel method to label polyclonal human immunoglobulin G (IgG) with 99mTc through the nicotinyl hydrazine derivative (HYNIC) has shown promising results in the detection of experimental infection. In this study, 99mTc-labeled HYNIC-IgG was directly compared to (111)In-labeled diethylenetriaminepentaacetic acid (DTPA)-IgG in patients suspected of infectious or inflammatory disease.
  
  
  METHODS
  Thirty-seven patients (22 women and 15 men; mean age = 54 yr, range = 17-78 yr) with 39 suspected infectious or inflammatory foci were prospectively studied. After administration of 740 MBq 99mTc-HYNIC-IgG, imaging was performed at 4 and 24 hr postinjection. To avoid cross-over activity, (111)In-DTPA-IgG was injected 24 hr after 99mTc-HYNIC-IgG and imaged at 4, 24 and 48 hr postinjection. The scintigraphic results were confirmed by microbiological, histological, radiological and clinical methods.
  
  
  RESULTS
  Technetium-99m-HYNIC-IgG and (111)In-DTPA-IgG scintigraphy showed 100% concordancy. All 17 patients with proven infection or inflammation (19 foci, mainly localized in the locomotor system) had positive scintigraphic findings. No false-negative scintigrams were recorded. In three patients, the scintigrams were concordantly false-positive. As a result, the sensitivity and specificity of imaging infectious or inflammatory foci with 99mTc-HYNIC-IgG and (111)In-DTPA-IgG in these patients were 100% and 85%, respectively.
  
  
  CONCLUSIONS
  Technetium-99m-HYNIC-IgG scintigraphy is equally as effective as (111)In-IgG scintigraphy for the detection of infection and inflammation. The apparent physical and logistic advantages of 99mTc over (111)In make 99mTc-HYNIC-IgG a promising new radiopharmaceutical for imaging infection and inflammation.
authors.affiliation: Department of Nuclear Medicine, University Hospital Nijmegen, The Netherlands.
authors.forename: E T
authors.initials: ET
authors.lastname: Dams
authors.forename: W J
authors.initials: WJ
authors.lastname: Oyen
authors.forename: O C
authors.initials: OC
authors.lastname: Boerman
authors.forename: R A
authors.initials: RA
authors.lastname: Claessens
authors.forename: A B
authors.initials: AB
authors.lastname: Wymenga
authors.forename: J W
authors.initials: JW
authors.lastname: van der Meer
authors.forename: F H
authors.initials: FH
authors.lastname: Corstens
mesh_terms: D001424:Bacterial Infections / Q000000981:diagnostic imaging*; D001850:Bone Diseases, Infectious / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007074:Immunoglobulin G; D007205:Indium Radioisotopes; D007249:Inflammation / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D004369:Pentetic Acid; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D018461:Soft Tissue Infections / Q000000981:diagnostic imaging
chemical_list: D007074:Immunoglobulin G; D007205:Indium Radioisotopes; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C099153:technetium Tc 99m hydrazinonicotinate-IgG; D004369:Pentetic Acid