The Labeled-Leukocyte Scan in the Study of Abdominal Abscesses

Liberatore, M.; Calandri, Enrico; Ciccariello, Gabriele; Fioravanti, Miriam; Megna, Valentina; Rampin, Lucia; Marzola, Maria Cristina; Zerizer, Imene; Al-Nahhas, Adil; Rubello, Domenico

doi:10.1007/s11307-010-0314-0

Cited by 9 publications

(6 citation statements)

References 40 publications

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“…Following successful introduction, larger-scale clinical work will be needed for an accurate definition of the role of WBC CZT imaging for guidance of therapy and improvement of outcome in endocarditis. Second, the majority of our patients had suspected device-related endocarditis, but a fraction had 26 Also, the location of the infectious focus (mitral vs. aortic valve) is not expected to play a significant role, given the higher photon energy of In-111 which renders the WBC signal less likely to be attenuated, and the extensive experience with leukocyte imaging in other areas of the body where no major associations between focus depth/ location and detection sensitivity was encountered. Fourth, the effect of antibiotic treatment on test accuracy has not been investigated specifically.…”

Section: Discussionmentioning

confidence: 90%

Simultaneous dual-isotope solid-state detector SPECT for improved tracking of white blood cells in suspected endocarditis

et al. 2016

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AimsHigh-energy resolution and sensitivity of novel cadmium-zinc-telluride (CZT) detector equipped SPECT systems facilitate simultaneous imaging of multiple isotopes and may enhance the detection of molecular/cellular signals. This may refine the detection of endocarditis. This study was designed to determine the feasibility and diagnostic accuracy of simultaneous imaging of inflammation with 111 In-labeled white blood cells (WBCs) and myocardial perfusion with 99m Tc-sestamibi, for localization of WBCs relative to the valve plane in suspected endocarditis. Methods and resultsA dedicated cardiac CZT camera (Discovery 530c, GE Healthcare) was employed. Anthropomorphic thorax phantom studies were followed by clinical studies in 34 patients with suspected infection of native valves (n ¼ 12) or implants (n ¼ 22 In activity as high as 2.5* 99m Tc activity. In patients, image quality was superior for CZT imaging vs. conventional SPECT-CT and planar scintigraphy (P , 0.01). Cadmium-zinc-telluride dual isotope imaging improved reader confidence for detection of inflammatory foci. Diagnostic accuracy based on surgery or Duke Criteria during follow-up was highest for CZT imaging (P , 0.001). ConclusionNovel CZT SPECT technology improves the accuracy of molecular/cellular cardiac imaging. Simultaneous multi-isotope imaging with 111 In and 99m Tc is feasible and aids in the workup of suspected endocarditis.--

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Section: Discussionmentioning

confidence: 90%

Simultaneous dual-isotope solid-state detector SPECT for improved tracking of white blood cells in suspected endocarditis

et al. 2016

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“…Our study suggests that a condition of protein dispersion without the presence of a leucokyte-mediated inflammation could exist. In fact, it is well known that the uptake mechanism of HIG is non-specific and it relies on pathophysiological changes occurring at the inflammation site such as the enhanced vascular permeability, blood flow, and transudation of plasma proteins in absence of inflammation leukocyte-mediated [20]. On the other hand, WBCs have been widely used in the study of Crohn's disease both for the evaluation of the extent and inflammatory activity of the disease, and for the study of abscesses and abdominal fistulas that can complicate the disease [21].…”

Section: Discussionmentioning

confidence: 99%

The Usefulness of Scintigraphic Studies in the Assessment of Asymptomatic Bowel Disease in Patients with Primary Antibody Diseases

Milito

Cinetto

Megna

et al. 2020

JCM

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Enteropathy may be the first presentation of immunodeficiency or it may occur during the course of the disease and in association with malabsorption in patients affected by primary antibody diseases. For these patients, immunoglobulin G (IgG) replacement therapy prevents infectious and non-infectious complications. Nonetheless some patients cannot achieve optimal IgG trough levels, even when treated with high Ig doses in absence of protein-losing syndromes. We investigated seven patients affected by common variable immunodeficiencies (CVIDs) and treated with high Ig doses (600–800 mg/kg/month) showing low IgG trough level. Patients underwent abdominal scintigraphy with human polyclonal immunoglobulin G labeled with 99mTc and with white blood cells labeled by 111 Indium-oxinate to investigate asymptomatic bowel inflammation. A concentration of labeled leukocytes in abdominal segments greater than that observed with human polyclonal immunoglobulin G was evident only in one patient. In five patients a slight concentration of both radiopharmaceuticals was reported, due to mild intestinal inflammatory response. These data might be related to mild increase of capillary permeability in the absence of inflammation leukocyte mediated. This study discloses a new cause of IgG-accelerated catabolism due to inflammatory bowel conditions without diarrhea in CVID patients.

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“…Gallium scan has been compared to CT in the detection of intra-abdominal abscess after colorectal surgery (sensitivity, specificity and accuracy of 100%, 78% and 91%, respectively versus 93%, 100%, and 96%) [223,259]. Leukocyte scintigraphy is sensitive in detecting abdominal abscess in different locations (76-100% sensitivity, 85-100% specificity, 88-100% accuracy) [260] except for the liver and spleen due to physiological localization of labeled cells in these organs [261]. The addition of 99m Tc-sulfur colloid liver-spleen scan to the WBC increases the sensitivity of the WBC scan in the detection of hepatosplenic infections [260,262].…”

Section: Abdominal Infection 231 Abdominal Abscessmentioning

confidence: 99%

“…Leukocyte scintigraphy is sensitive in detecting abdominal abscess in different locations (76-100% sensitivity, 85-100% specificity, 88-100% accuracy) [260] except for the liver and spleen due to physiological localization of labeled cells in these organs [261]. The addition of 99m Tc-sulfur colloid liver-spleen scan to the WBC increases the sensitivity of the WBC scan in the detection of hepatosplenic infections [260,262]. Furthermore, WBC scintigraphy can reveal unsuspected extra-abdominal sites of infection [260,263].…”

Section: Abdominal Infection 231 Abdominal Abscessmentioning

confidence: 99%

“…The addition of 99m Tc-sulfur colloid liver-spleen scan to the WBC increases the sensitivity of the WBC scan in the detection of hepatosplenic infections [260,262]. Furthermore, WBC scintigraphy can reveal unsuspected extra-abdominal sites of infection [260,263]. WBC scan has been reported to be helpful in intra-abdominal infection patient management in 76% of cases [260,264].…”

Section: Abdominal Infection 231 Abdominal Abscessmentioning

confidence: 99%

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Current Status of Molecular Imaging in Infections

Sollini

Lauri²,

Boni

et al. 2018

CPD

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There is an increased need to find non-invasive tools for early diagnosis and follow-up of infections. Nuclear medicine techniques may be used to diagnose, localize and evaluate the severity and the extent of infections before the occurrence of anatomical abnormalities. This review focuses on different approaches based on radiolabelled cells, peptides and antibodies or [18F]FDG to image infective diseases in agreement with what is being jointly evaluated by the European Association of Nuclear Medicine (EANM). This is particularly relevant, since the EANM has strated a wide program of collaboration with other European clinical societies to define common diagnostic flow-charts in many of these infective diseases. It emerges the role of radiolabelled WBC by SPECT/CT for prosthetic joint infections and of FDG by PET/CT for spondylodiscitis. Comparable values of accuracy have been described for WBC and FDG in the diagnosis of vascular fgraft infections, diabetic gfoot, endocarditis and peripheral bone osteomyelitis, with some exceptions.

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The Labeled-Leukocyte Scan in the Study of Abdominal Abscesses

Abstract: LS is the more sensitive method to localize abdominal abscesses and may guide dedicated US and CT investigations to improve their diagnostic potential. Further diagnostic evolution is expected from the routine use of hybrid SPECT/CT systems.

Cited by 9 publications

References 40 publications

Simultaneous dual-isotope solid-state detector SPECT for improved tracking of white blood cells in suspected endocarditis

Simultaneous dual-isotope solid-state detector SPECT for improved tracking of white blood cells in suspected endocarditis

The Usefulness of Scintigraphic Studies in the Assessment of Asymptomatic Bowel Disease in Patients with Primary Antibody Diseases

Current Status of Molecular Imaging in Infections

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