title: Intact versus fragmented 99mTc-monoclonal antibody imaging of infection in patients with septically loosened total knee arthroplasty.
abstract: OBJECTIVE
  This prospective study compared the diagnostic accuracy of imaging using an intact murine antigranulocyte antibody 99mTc-besilesomab, and a murine antibody Fab fragment 99mTc-sulesomab, in patients with suspected septically loosened total knee arthroplasty.
  
  
  METHODS
  Images from 20 patients who underwent threephase bone scintigraphy followed by imaging using 99mTc-besilesomab (n=10) or 99mTc-sulesomab (n=10) were evaluated and compared. Final diagnosis was determined by microbiological evaluation of aspirated synovial fluid, intraoperative samples through the clinical course, or by long-term follow-up.
  
  
  RESULTS
  Prosthesis infection was shown in 18 patients. At 4 and 24 h after intravenous injection, absolute uptake of 99mTc-besilesomab was significantly higher than 99mTc-sulesomab in infected knee joints. Infected-to-healthy knee activity ratios were similar at 4 and 24 h for 99mTc-besilesomab and 99mTc-sulesomab.
  
  
  CONCLUSIONS
  Both 99mTc-besilesomab and 99mTc-sulesomab had similar diagnostic accuracy for the detection of septic arthroplasty. If repeated use of immunoscintigraphy is needed for follow-up, 99mTc-sulesomab should be preferred over 99mTc-besilesomab since it is known to be well tolerated and without side effects or incompatibility reactions.
authors.affiliation: Department of Nuclear Medicine, Philipps University, Marburg, Germany. Nuklearmedizin-Gratz@gmx.net
authors.forename: S
authors.initials: S
authors.lastname: Gratz
authors.forename: P
authors.initials: P
authors.lastname: Reize
authors.forename: A
authors.initials: A
authors.lastname: Pfestroff
authors.forename: H
authors.initials: H
authors.lastname: Höffken
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000493:pharmacokinetics; D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D007720:Knee Prosthesis / Q000382:microbiology; D008297:Male; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging* / Q000382:microbiology; D013290:Streptococcal Infections / Q000000981:diagnostic imaging* / Q000382:microbiology; D013297:Streptococcus pyogenes; D013582:Synovial Fluid / Q000382:microbiology
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019275:Radiopharmaceuticals; C578104:besilesomab; C101172:Sulesomab