Labelled leukocytes for diagnosis of infectious diseases. Our experience in labelling and clinical usefulness.
BACKGROUND
To review our experience in infectious diseases diagnosis, using a simple labelling technique.


METHODS
We made 101 scans in 91 patients with suspected infectious diseases confirmed by clinical, histologic or cultural specimens; a clinical or instrumental follow-up was available for every patient. Patients were divided into four subgroups: A: Inflammatory Bowel Diseases; B: Septic Syndromes; C: Bone diseases; D: Others. We used 99mTc-HMPAO in 80 scans and 111In in 21. In 20/80 frozen and stored HMPAO was used.


RESULTS
99mTc-HMPAO frozen and stored labelling yield was: 60%(SD15%), 99mTcHMPAO: 62(12)(p n.s.), 111In 75%(10%), (p < 0.05). Frozen-stored HMPAO was sterile and apyrogen. 27 had positive scan without leukocytosis or neutrophilia. No correlation between leukocytosis or neutrophilia and yield was observed. Transit lung times ranged between 14-16 min without differences among three radiopharmaceuticals. In each Group and in the sample as a whole True Positive, False Positive, True Negative, False Negative, Sensitivity, Specificity and Accuracy, were calculated. In Group B and in the sample as a whole Predictive Positive Value and Negative Predictive Value were also evaluated.


CONCLUSIONS
Labelling yields and "viability" were good using the three radiopharmaceuticals; labelling procedure was simple and safe. Accuracy PPV, NPV, cost-effectiveness were good; 111In is the choice for diagnosis of bone and joint infections. Frozen-stored HMPAO should be introduced as a cost-saving labelling procedure in practice.
Institute of Radiological Science, Department of Nuclear Medicine, University of Milan, Ospedale S. Paolo, Milan. taluca@tiscalinet.it
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Tagliabue
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Majoli
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Pajoro
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Musarra
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Di Leo
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Del Sole
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Bestetti
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Tarolo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001850:Bone Diseases, Infectious / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D007249:Inflammation / Q000000981:diagnostic imaging; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D015125:Oxyquinoline / Q000031:analogs & derivatives*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D018746:Systemic Inflammatory Response Syndrome / Q000000981:diagnostic imaging*; D019690:Technetium Tc 99m Exametazime
D007205:Indium Radioisotopes; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C032950:indium oxine; D019690:Technetium Tc 99m Exametazime; D015125:Oxyquinoline