Clinical validation of the avidin/indium-111 biotin approach for imaging infection inflammation in orthopaedic patients

被引:33
作者
Lazzeri, E
Manca, M
Molea, N
Marchetti, S
Consoli, V
Bodei, L
Bianchi, R
Chinol, M
Paganelli, G
Mariani, G
机构
[1] Univ Genoa, Nucl Med Serv, DIMI, I-16132 Genoa, Italy
[2] European Inst Oncol, Nucl Med Serv, Milan, Italy
[3] Univ Pisa, Inst Orthoped, Pisa, Italy
[4] Univ Pisa, Reg Ctr Nucl Med, Pisa, Italy
关键词
avidin streptavidin; indium-111-biotin; inflammation infection; scintigraphic imaging; orthopaedic patients;
D O I
10.1007/s002590050428
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
We report here the results of a validation study of the avidin/indium-111 biotin approach in patients with skeletal lesions. This study involved 54 patients with orthopaedic conditions: 20 patients with intermediate suspected osteomyelitis of the trunk, 19 patients with infection/inflammation of prosthetic joint replacements, and 15 patients with suspected osteomyelitis of appendicular bones. Avidin (3 mg) was injected as an i.v. bolus, followed 4 h later by In-111-biotin; imaging was acquired 30 min and 16-18 h after administration of In-111-biotin. Technetium-99m hexamethylpropylene amine oxime (Tc-99m-HMPAO)-labelled leucocyte scintigraphy was performed in 39/54 patients. The overall sensitivity of the avidin/In-111-biotin scan was 97.7% (versus 88.9% for Tc-99m-HMPAO leucocyte scintigraphy). While the diagnostic performance of avidin/(111)Inbiotin scintigraphy was similar to that of Tc-99m-HMPAO leucocyte scintigraphy in patients with prosthetic joint replacements or osteomyelitis of appendicular bones, the avidin/In-111-biotin approach clearly performed better than 99mTc-HMPAO leucocyte scintigraphy in patients with suspected osteomyelieis of the trunk (100% sensitivity, specificity and accuracy Versus 50% sensitivity, 100% specificity and 66.7% accuracy for Tc-99m-HMPAO-leucocyte scintigraphy). These results demonstrate the feasibility of the avidin/In-111-biotin approach for imaging sites of infection/inflammation in the clinical setting. Although no systematic advantages:of avidin/In-111-biotin scintigraphy were found versus Tc-99m-HMPAO leucocyte scintigraphy, the newer scintigraphic method is more practicable and involves lower biological risk for the operators.
引用
收藏
页码:606 / 614
页数:9
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