Gallium Citrate Ga 67 Imaging in Patients With Suspected Inflammatory Processes

Kumar, Bharath N.

doi:10.1001/archsurg.1975.01360160075013

Cited by 37 publications

(1 citation statement)

References 13 publications

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“…The excretion of 67Ga by the kidneys and gastrointestinal tract severely limits the diagnostic potential of this technique for the localization of intraperitoneal abscesses. Many clinical investigations utilizing intravenously injected 67Ga scintiscans have demonstrated good results with sensitivity ranging from 57-100%, specificity ranging from 93% to 100%, and overall diagnostic accuracy ranging between 84% and 100% [22][23][24][25][26][27][28][29]. False-positive results are secondary to gallium accumulation within the bowel wall, in healing wounds, and, theoretically, at every site of inflammation; it is not specific for infection.…”

Section: Gallium Scintiscanningmentioning

confidence: 99%

Radiolabeled autologous leukocyte scanning in abscess detection

1980

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Use of ultrasonography, computed tomography, 67galliumscintiscanning, and 111indium seintiscanning of labeled autologous leukocytes in the detection of intra-abdominal in. The clinician is frequently presented with a febrile patient in whom the fever source is unknown. Correct diagnosis and prompt surgical treatment is particularly important in intra-abdominal infection where, untreated, the abscess has an associated mortality rate that ranges from 2% (appendicial abscess)to greater than 40% (pancreatic abscess) [1]. The associated morbidity, reflected in increased hospital stay and cost, is significant [1]. Classical signs and symptoms of occult infection are frequently absent, present only in retrospect, or misleading. Among 60 patients with subphrenic abscess reported by De Cosse et al. [2], 11 were first discovered at postmortem examination. In a recent study of 93 patients with documented subphrenic abscess [3], abdominal pain was absent in 62%, fever was absent in 18%, and wound drainage was absent in 82%; there was a mean delay in diagnoses of 5.5 weeks. At the present time no diagnostic modality is consistently successful in diagnosing and localizing these lesions. Abnormal findings utilizing conventional x-ray techniques have been disappointingly infrequent; 18-61% of patients have had an abnormal chest x-ray and 14-80% of patients have had positive findings on abdominal x-rays in the face of subphrenic abscess [4]. Recently, newer techniques have been developed and perfected to facilitate early diagnosis of septic foci. The purpose of this paper is to review the methodology and accuracy of several of these techniques and to relate our own experience with the use of l~lindium radioactive labeling of polymorphonuclear leukocytes in the detection of a septic source. UltrasonographyMechanical vibrations at high frequencies ranging between 1 and 5 MHz form the basis of ultrasonography. A transducer is used to contact the skin surface and to transmit the mechanical energy of the high frequency sound waves. Sound energy is reflected back toward the transducer after contact with successive tissue interfaces. Reception by the transducer generates an electrical signal that is transmitted to an oscilloscope where the reflections are imaged. The factors affecting echo formation have been reviewed by Ferruci [5]. Internal echos on gray-scale ultrasonography are the result of collagen, the presence of which enhances the sound velocity in tissue. The varying elastic properties of the intra-abdominal organs distinguish one from another via their sound wave reflections. Various pathologic processes alter the sound waves in recognizable ways; in addition, localized collections of

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Section: Gallium Scintiscanningmentioning

confidence: 99%

Radiolabeled autologous leukocyte scanning in abscess detection

1980

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A Diagnostic Approach to the Adult With Fever of Unknown Origin

Esposito¹

1979

Arch Intern Med

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Gallium 67 Scanning for the Diagnosis of Infection in Children

Cox

Hughes²

1979

Arch Pediatr Adolesc Med

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\s=b\ Gallium 67 scintigraphy was studied prospectively in 26 children with clinically suspected abscesses. Scan interpretation agreed with the clinical outcome in 21 patients (81%). The true-negative rate was 71% and the true-positive rate was 92%. False-positive scans were related to bleeding and bone infarcts. False-negative scans were related to neutropenia (<500 neutrophils/cu mm) and to lesions smaller than 1 cm. Gallium scanning is a safe and reliable method of diagnosis of infection in children, except for patients with neutropenia or whose lesions are smaller than 1 cm. Two-hour scans may be useful in some patients, particularly those with osteomyelitis.(Am J Dis Child 133: [1171][1172][1173] 1979) Gal l i um 67 is a gamma-emitting radionuclide with a physical half-life of 78 hours and gamma emis¬ sions of 93 keV (40%), 184 keV (24%), 296 keV (22%), and 388 keV (7%).' As the citrate salt, it is useful in the diagnosis of inflammatory disease, particularly abscesses, due to its uptake by phagocytizing cells, such as neutrophils2 and macrophages.3 It has been in clinical use for this purpose, primarily in adults, since 1971.4 Re¬ ports of gallium scans in children with infection, however, have usually con-

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Gallium Citrate Ga 67 Imaging in Patients With Suspected Inflammatory Processes

Cited by 37 publications

References 13 publications

Radiolabeled autologous leukocyte scanning in abscess detection

Radiolabeled autologous leukocyte scanning in abscess detection

A Diagnostic Approach to the Adult With Fever of Unknown Origin

Gallium 67 Scanning for the Diagnosis of Infection in Children

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