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Aims: The diagnosis of deep seated bacterial infections, such as intra-abdominal abscesses, endocarditis, and osteomyelitis, can be difficult and delayed, thereby compromising effective treatment. This study assessed the efficacy of a new radioimaging agent, Tc-99m ciprofloxacin (Infecton), in accurately detecting sites of bacterial infection. Methods: Eight hundred and seventy nine patients with suspected bacterial infection underwent Infecton imaging and microbiological evaluation. The sensitivity and specificity of Infecton in detecting sites of bacterial infection were determined with respect to Centres of Disease Control, World Health Organisation, and Dukes's criteria. Results: Five hundred and seventy four positive and 295 negative images were produced. These included 528 true positives, 46 false positives, 205 true negatives and 90 false negatives, giving an overall sensitivity of 85.4% and a specificity of 81.7% for detecting infective foci. Sensitivity was higher (87.6%) in microbiologically confirmed infections. Conclusions: Infecton is a sensitive technique, which aids in the earlier detection and treatment of a wide variety of deep seated bacterial infections. The ability to localise infective foci accurately is also important for surgical intervention, such as drainage of abscesses. In addition, serial imaging with Infecton might be useful in monitoring clinical response and optimising the duration of antimicrobial treatment.

Eosinophils are the major cellular effectors of allergic inflammation and represent an important therapeutic target. Although the genesis and activation of eosinophils have been extensively explored, little is known about their intravascular kinetics or physiological fate. This study was designed to determine the intravascular life span of eosinophils, their partitioning between circulating and marginated pools, and sites of disposal in healthy persons. Using autologous, minimally manipulated 111-Indium-labeled leukocytes with blood sampling, we measured the eosinophil intravascular residence time as 25.2 hours (compared with 10.3 hours for neutrophils) and demonstrated a substantial marginated eosinophil pool. ␥ camera imaging studies using purified eosinophils demonstrated initial retention in the lungs, with early redistribution to the liver and spleen, and evidence of recirculation from a hepatic pool. This work provides the first in vivo measurements of eosinophil kinetics in healthy volunteers and shows that 111-Indium-labeled eosinophils can be used to monitor the fate of eosinophils noninvasively. (Blood. 2012;120(19):4068-4071) IntroductionEosinophils play a key role in allergic inflammation 1 and represent an important therapeutic target in asthma and other allergic diseases. They have the capacity to release histotoxic substances, including granule proteins, inflammatory cytokines, and reactive oxygen metabolites, which cause bronchoconstriction, epithelial damage, hyper-responsiveness, and airway remodeling. [2][3][4][5][6] Much is known about the cellular mechanisms regulating the development and maturation of eosinophils, their release from the bone marrow, and the processes involved in their recruitment, activation, and clearance during allergic inflammation. 7-11 By contrast, very little is known about the physiology of circulating eosinophils in humans. Because of the relative scarcity of eosinophils in the blood of healthy persons (range, 0.0-0.4 ϫ 10 9 /L), previous attempts to study eosinophil kinetics have been restricted to patients with hypereosinophilia, 12-14 hampered by label reuse after pulse injection of 3 H-thymidine, 15 or relied on autoradiographs developed Ͼ 500 days. 16 We have used 111-Indiumlabeled mixed leukocytes with postinjection isolation of eosinophils to ascertain their intravascular life span, and subsequently purified 111-Indium-labeled autologous eosinophils with ␥ camera imaging to assess organ-specific trafficking in vivo. We have demonstrated an intravascular lifespan for circulating eosinophils exceeding 24 hours and revealed extensive intravascular margination of these cells, together with evidence of recirculation from a hepatic pool. Methods ParticipantsHealthy male and female adults with normal lung function and eosinophil counts (range, 0.02-0.38 ϫ 10 9 /L) gave written informed consent in accordance with the Declaration of Helsinki. The study was approved by Cambridgeshire Research Ethics Committee (09/H0308/119) and the Administration of Radioactive Substan...