Inflammation: imaging with Tc-99m HMPAO-labeled leukocytes.

Roddie, Mary E.; Peters, A. M.; Danpure, H. J.; Osman, Safiye; Henderson, B. L.; Lavender, J. P.; Carroll, M. J.; Neirinckx, R.D.; Kelly, James D.

doi:10.1148/radiology.166.3.3340775

Cited by 187 publications

(52 citation statements)

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“…Our results confirm the high accuracy of 99mTc-WBC scans (96%) for the diagnosis of IBD, as previously reported [16][17][18][19][20]. lllIn-lgG scanning does not seem to be as accurate (sensitivity: 70%; accuracy: 74%) in diagnosing IBD (Figs.…”

Section: Discussionsupporting

confidence: 91%

Simultaneous administration of111In-human immunoglobulin and99mTc-HMPAO labelled leucocytes in inflammatory bowel disease

et al. 1995

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Technetium-99m hexamethylpropylene amine oxime (HMPAO) labelled leucocytes and indium-111 polyclonal immunoglobulin (IgG) were simultaneously injected into a group of 27 patients routinely referred for the investigation of inflammatory bowel disease (IBD). Ten-minute anterior abdomen and tail on detector views were obtained at 30 min, 4 h and 24 h p.i. of both tracers. The diagnosis of IBD was obtained in all cases by endoscopy with biopsy and/or surgery. Images were blindly evaluated by two experienced observers who only knew of the clinical suspicion of IBD. IBD was confirmed in 20 patients (12 with Crohn's disease and eight with ulcerative colitis). Sensitivity, specificity and accuracy were 100%, 85% and 96% respectively for labelled leucocytes and 70%, 85% and 74% for IgG. Both IgG and leucocyte scans were normal in six out of seven patients in whom a diagnosis of IBD was excluded; the remaining patient, with ischaemic colitis, was falsely positive with both agents. As far as disease extension is concerned, the IgG study localized 27 diseased segments, whereas 49 were seen with the leucocyte study. Eighty-four segments were normal and 25 showed tracer uptake with both agents. Twenty-four were positive only with the leucocyte study and two were positive only with the IgG study. Agreement between the agents was 80.7%. These results confirm that 111In-human polyclonal scintigraphy is less sensitive than 99mTc-HMPAO scintigraphy both for the diagnosis of IBD and in the evaluation of disease extension. Nevertheless, if leucocyte labelling is not available, labelled IgG can be used only for diagnostic purposes.

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Section: Discussionsupporting

confidence: 91%

Simultaneous administration of111In-human immunoglobulin and99mTc-HMPAO labelled leucocytes in inflammatory bowel disease

et al. 1995

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“…The radiation-absorbed estimates for 99m Tc-HMPAOlabeled monocytes, compared with stabilized 99m Tc-HMPAO-labeled WBCs (14), were a fraction higher but comparable with 99m Tc-HMPAO-labeled granulocytes (19) and the effective dose published in ICRP Publication 62 (20).…”

Section: Discussionmentioning

confidence: 62%

Biodistribution and Radiation Dosimetry of ^99mTc-HMPAO–Labeled Monocytes in Patients with Rheumatoid Arthritis

Bennink¹,

Thurlings²,

Hemert³

et al. 2008

J Nucl Med

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Rheumatoid arthritis (RA) involves the accumulation of monocytederived macrophages in the affected synovial tissue. This process of cell migration could be portrayed scintigraphically to monitor noninvasively the effects of therapy on the progress of the disease. For this purpose, labeling of purified autologous monocytes with 99m Tc-hexamethylpropyleneamine oxime ( 99m Tc-HMPAO) at very high specific radioactivity has recently been developed. The aim of this study was to assess the biodistribution and radiation dosimetry of 99m Tc-HMPAO-labeled monocytes in adult patients with RA. Methods: In 8 patients with RA, monocytes were isolated from 100 mL of blood and labeled with 99m Tc-HMPAO to a yield of 10 Bq/cell. Multiple whole-body scans were performed up to 20 h after reinjection of an average of 200 MBq of 99m Tc-HMPAO-labeled monocytes. Urine and blood samples were collected. The fraction of administered activity in 7 source organs was quantified from the attenuation-corrected geometric mean counts in conjugate views. Radiation-absorbed doses were estimated with OLINDA/EXM software. Results: Autologous monocytes labeled with 99m Tc-HMPAO at high intracellular yields showed in vivo kinetics comparable with labeled leukocytes, with initial trapping in the lungs followed by distribution into the liver, spleen, and bone marrow. The radiation-absorbed estimates for 99m Tc-HMPAO-labeled monocytes were comparable with those for 99m Tc-HMPAOlabeled mixed white blood cells, with an effective dose of 0.011 mSv/MBq. Conclusion: 99m Tc-HMPAO-labeled monocytes have biodistribution and radiation dosimetry similar to those of 99m Tc-HMPAO-labeled mixed white blood cells and might therefore be used for in vivo monitoring of immunomodulating therapy in patients with RA.Key Words: joint/muscle; radiobiology/dosimetry; radiopharmaceuticals; biodistribution; monocytes; rheumatoid arthritis Nucl Med 2008; 49:1380 49: -1385 49: DOI: 10.2967 Rheumat oid arthritis (RA) is a chronic inflammatory disease affecting synovial tissue in multiple joints. Monocytederived macrophage cells accumulate in the inflamed synovium and thereby contribute to the perpetuation of inflammation and destruction of the affected joints (1). Reduced migration of inflammatory cells such as monocytes or macrophages into the synovial compartment or a decrease in the retention of these cells at the site of inflammation may be attained by treatment of patients with antibodies against tumor necrosis factor-a (TNF-a) (2) or perhaps with chemokine receptor antagonists (3). JFor noninvasive monitoring of treatment, migration of cells toward sites of inflammation in vivo can be portrayed scintigraphically after radiolabeling of the cells in vitro with 99m Tc-labeled hexamethylpropyleneamine oxime (HMPAO). Therefore, labeling of purified autologous monocytes with 99m Tc-HMPAO at very high specific radioactivity has recently been developed (4).In this study, the biodistribution and radiation dosimetry of 99m Tc-HMPAO-labeled monocytes were assessed in adult patients w...

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“…32 Nonspecific bowel activity, unrelated to inflammatory bowel disease, has in other studies been observed in the small bowel and proximal colon as early as 30 minutes after injection of technetium-99m exametazime-labeled cells 33 and been found in about 15% of subjects within the first hour. 29,34 In other series, such activity has first been seen on 2-hour images in 7% or on 3-4-hour images in 5%-28% of examinations 31,[35][36][37] or to occur only later than 3 hours. 38 We applied neither fasting conditions before scanning 39 nor injection of pethidine before the reinjection of labeled cells, 40 which has been shown to increase the frequency of gall bladder visualization from 10% to 44% and from 29% to 72%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohnʼs disease

Almér

Granérus²,

Ström

et al. 2007

Inflammatory Bowel Diseases

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Inflammation: imaging with Tc-99m HMPAO-labeled leukocytes.

Cited by 187 publications

References 0 publications

Simultaneous administration of111In-human immunoglobulin and99mTc-HMPAO labelled leucocytes in inflammatory bowel disease

Simultaneous administration of111In-human immunoglobulin and99mTc-HMPAO labelled leucocytes in inflammatory bowel disease

Biodistribution and Radiation Dosimetry of ^99mTc-HMPAO–Labeled Monocytes in Patients with Rheumatoid Arthritis

Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohnʼs disease

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Inflammation: imaging with Tc-99m HMPAO-labeled leukocytes.

Cited by 187 publications

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Simultaneous administration of111In-human immunoglobulin and99mTc-HMPAO labelled leucocytes in inflammatory bowel disease

Simultaneous administration of111In-human immunoglobulin and99mTc-HMPAO labelled leucocytes in inflammatory bowel disease

Biodistribution and Radiation Dosimetry of 99mTc-HMPAO–Labeled Monocytes in Patients with Rheumatoid Arthritis

Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohnʼs disease

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Biodistribution and Radiation Dosimetry of ^99mTc-HMPAO–Labeled Monocytes in Patients with Rheumatoid Arthritis