Detection of acute inflammation with /sup 111/In-labeled nonspecific polyclonal IgG

Journal Article · Sat Oct 01 04:00:00 EDT 1988 · Semin. Nucl. Med.; (United States)

DOI:https://doi.org/10.1016/S0001-2998(88)80042-4· OSTI ID:6499066

Fischman, A J; Rubin, R H; Khaw, B A; Callahan, R J; Wilkinson, R; Keech, F; Nedelman, M; Dragotakes, S; Kramer, P B; LaMuraglia, G M

The detection of focal sites of inflammation is an integral part of the clinical evaluation of the febrile patient. When anatomically distinct abscesses are present, lesion detection can be accomplished by standard radiographic techniques, particularly in patients with normal anatomy. At the phlegmon stage, however, and in patients who have undergone surgery, these techniques are considerably less effective. While radionuclide methods, such as Gallium-67 (67Ga)-citrate and Indium-111 (111In)-labeled WBCs have been relatively successful for the detection of early inflammation, neither approach is ideal. In the course of studies addressing the use of specific organism-directed antibodies for imaging experimental infections in animals, we observed that nonspecific polyclonal immunoglobulin G (IgG) localized as well as specific antibodies. Preliminary experiments suggested that the Fc portion of IgG is necessary for effective inflammation localization. Since polyclonal IgG in gram quantities has been safely used for therapy in patients with immune deficiency states, we decided to test whether milligram quantities of radiolabeled IgG could image focal sites of inflammation in humans. Thus far, we have studied a series of 84 patients with suspected lesions in the abdomen, pelvis, vascular grafts, lungs, or bones/joints. In 48 of 52 patients with focal lesions detected by surgery, computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound (US), the IgG scan correctly localized the site, while 31 patients without focal inflammation had no abnormal focal localization of the radiopharmaceutical. Four patients had false negative scans and one patient had a false positive scan. For this small series, the overall sensitivity and specificity were 92% and 95%, respectively. In this report, we review our experience with this exciting new agent.

• Research Organization: Massachusetts General Hospital, Boston (USA)
• OSTI ID: 6499066
• Journal Information: Semin. Nucl. Med.; (United States), Journal Name: Semin. Nucl. Med.; (United States) Vol. 18:4; ISSN SMNMA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ABDOMEN
ANIMALS
BETA DECAY RADIOISOTOPES
BIOLOGICAL LOCALIZATION
BLOOD VESSELS
BODY
BODY AREAS
BONE JOINTS
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
ELECTRON CAPTURE RADIOISOTOPES
GALLIUM 67
GALLIUM ISOTOPES
GLOBULINS
IMMUNOGLOBULINS
INDIUM 111
INDIUM ISOTOPES
INFLAMMATION
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LUNGS
MAMMALS
MEDICINE
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
PELVIS
PROTEINS
RADIOIMMUNOSCINTIGRAPHY
RADIOISOTOPE SCANNING
RADIOISOTOPES
RATS
RESPIRATORY SYSTEM
RODENTS
SCINTISCANNING
SENSITIVITY ANALYSIS
SKELETON
SPECIFICITY
SURGERY
SYMPTOMS
VERTEBRATES