Technetium-99m labeled to human immunoglobulin G through the nicotinyl hydrazine derivative: a clinical study.
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.
Dams
E T
ET
Department of Nuclear Medicine, University Hospital Nijmegen, The Netherlands.
Oyen
W J
WJ
Boerman
O C
OC
Claessens
R A
RA
Wymenga
A B
AB
van der Meer
J W
JW
Corstens
F H
FH
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
D007074:Immunoglobulin G; D007205:Indium Radioisotopes; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C099153:technetium Tc 99m hydrazinonicotinate-IgG; D004369:Pentetic Acid