Diagnosis of Orthopedic Infection in Clinical Practice Using Tc-99m Sulesomab (Antigranulocyte Monoclonal Antibody Fragment Fab’2)

Vicente, A. García; Almoguera, M I; Alonso, Juan Carlos; Heffernan, Amelia Jiménez; Gómez, Alberto; Contreras, P I; Martín-Comín, J.

doi:10.1097/00003072-200412000-00001

Cited by 25 publications

(7 citation statements)

References 12 publications

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“…Therefore, similarly to in vitro labelled leucocytes, both radiopharmaceuticals are proposed as promising agents for imaging of inflammation and infection. The results of these agents for diagnosing PJI, however, have been variable [58][59][60][61][62][63].…”

Section: Bsmentioning

confidence: 99%

Prosthetic joint infections: radionuclide state-of-the-art imaging

Gemmel¹,

Wyngaert²,

Love

et al. 2012

Eur J Nucl Med Mol Imaging

165

151

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Prosthetic joint replacement surgery is performed with increasing frequency. Overall the incidence of prosthetic joint infection (PJI) and subsequently prosthesis revision failure is estimated to be between 1 and 3%. Differentiating infection from aseptic mechanical loosening, which is the most common cause of prosthetic failure, is especially important because of different types of therapeutic management. Despite a thorough patient history, physical examination, multiple diagnostic tests and complex algorithms, differentiating PJI from aseptic loosening remains challenging. Among imaging modalities, radiographs are neither sensitive nor specific and cross-sectional imaging techniques, such as computed tomography and magnetic resonance imaging, are limited by hardware-induced artefacts. Radionuclide imaging reflects functional rather than anatomical changes and is not hampered by the presence of a metallic joint prosthesis. As a result scintigraphy is currently the modality of choice in the investigation of suspected PJI. Unfortunately, there is no true consensus about the gold standard technique since there are several drawbacks and limitations inherent to each modality. Bone scintigraphy (BS) is sensitive for identifying the failed joint replacement, but cannot differentiate between infection and aseptic loosening. Combined bone/gallium scintigraphy (BS/GS) offers modest improvement over BS alone for diagnosing PJI. However, due to a number of drawbacks, BS/GS has generally been superseded by other techniques but it still may have a role in neutropenic patients. Radiolabelled leucocyte scintigraphy remains the gold standard technique for diagnosing neutrophil-mediated processes. It seems to be that combined in vitro labelled leucocyte/bone marrow scintigraphy (LS/BMS), with an accuracy of about 90%, is currently the imaging modality of choice for diagnosing PJI. There are, however, significant limitations using in vitro labelled leucocytes and considerable effort has been devoted to developing alternative radiotracers, such as radiolabelled HIGs, liposomes, antigranulocyte antibodies and fragments, as well as more investigational tracers such as radiolabelled antibiotics, antimicrobial peptides, bacteriophages and thymidine kinase. On the other hand, positron emission tomography (PET) is still growing in the field of PJI imaging with radiotracers such as (18)F-fluorodeoxyglucose (FDG), (18)F-FDG white blood cells and (18)F-fluoride. But unfortunately this superb tomographic technique will only receive full acceptance when specific PET uptake patterns can be successfully developed. The emergence of hybrid modality imaging using integrated single photon emission computed tomography (SPECT) and PET with computed tomography (SPECT/CT and PET/CT) may also have a contributing role for more accurate assessment of joint replacement complications, especially combined with new radiotracers such as (68)Ga and (64)Cu. Finally, in searching for infection-specific tracers, currently there is no such diagnostic agent available.

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Section: Bsmentioning

confidence: 99%

Prosthetic joint infections: radionuclide state-of-the-art imaging

Gemmel¹,

Wyngaert²,

Love

et al. 2012

Eur J Nucl Med Mol Imaging

165

151

View full text Add to dashboard Cite

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“…Les performances diagnostiques du sulesomab dans le cadre de l'infection de prothèses de hanche et de genou apparaissent variables avec peut-être une moindre sensibilité que la SPM [36][37][38]. Concernant le belisesomab, Richter et al ont montré une plus grande sensibilité de détection dans les infections chroniques en comparaison avec la SPM, mais une plus grande spécificité des polynucléaires autologues dans les infections [3,47].…”

Section: La Scintigraphie Aux Anticorps Anti-granulocytesunclassified

Imagerie scintigraphique de l’infection des prothèses de hanche et de genou

et al. 2013

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“…In our experience, we found it very helpful especially in children due to its availability in kit form, easy preparation, in-vivo application and the absence of significant side-effects. [67] In this case, it was negative which may be explained by the fact it was not an acute case or it may be a false negative result. Further studies are required to confirm either possibilities.…”

Section: Discussionmentioning

confidence: 84%

Chronic Recurrent Multifocal Osteomyelitis in Children: A Multidisciplinary Approach is needed to establish a Diagnosis

Alshammari

Usmani²,

et al. 2013

World J Nucl Med

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Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory disease of unknown cause. In general, CRMO follows a characteristic clinical course and is regarded at present as a distinct entity. It affects bone and occurs predominantly in children and adolescents. The clinical, radiologic and pathologic findings are non-specific. The recognition of this rare entity is often delayed and difficulties in patient management sometimes emerge from its usual protracted course. We present a 6-year-old girl diagnosed with CRMO involving tibia and lumbar vertebra where a multidisciplinary approach was essential in making the diagnosis.

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Diagnosis of Orthopedic Infection in Clinical Practice Using Tc-99m Sulesomab (Antigranulocyte Monoclonal Antibody Fragment Fab’2)

Abstract: Tc-99m-antigranulocyte monoclonal antibody fragment Fab'2 scintigraphy seems to be a useful method in the diagnosis of osteoarticular infection.

Cited by 25 publications

References 12 publications

Prosthetic joint infections: radionuclide state-of-the-art imaging

Prosthetic joint infections: radionuclide state-of-the-art imaging

Imagerie scintigraphique de l’infection des prothèses de hanche et de genou

Chronic Recurrent Multifocal Osteomyelitis in Children: A Multidisciplinary Approach is needed to establish a Diagnosis

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