PET with FDG-labeled Leukocytes versus Scintigraphy with<sup>111</sup>In-Oxine–labeled Leukocytes for Detection of Infection

Rini, Josephine N.; Bhargava, Kuldeep K.; Tronco, Gene; Singer, Carol; Caprioli, Russell; Marwin, Scott; Richardson, Hugh; Nichols, Kenneth; Pugliese, Paul; Palestro, Christopher J.

doi:10.1148/radiol.2382041993

Cited by 86 publications

(78 citation statements)

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“…The most frequent cause, aseptic loosening, is an inflammatory reaction to the prosthetic components (1). Subsequently, the particulate debris activates tissue phagocytes but cannot be broken down by cellular enzymes.…”

Section: Discussionmentioning

confidence: 99%

Painful Knee Arthroplasty

Traylor

Jolepalem

Mahajan

2014

Journal of Nuclear Medicine Technology

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A triple-tracer nuclear medicine study that incorporates 99m Tcsulfur colloid, 111 In-labeled leukocytes, and 99m Tc-methylene diphosphonate can be useful for the diagnosis of aseptic loosening in a patient after total-knee arthroplasty, as demonstrated in this case study. The triple-tracer technique takes less time and is more accurate than a bone scan alone. Thi s article discusses the importance of the use of a tripletracer study in the postoperative knee to diagnose an aseptic knee. The components of the triple tracer will be discussed, as well as how the results of this study can aid the orthopedic surgeon in designing a treatment plan that will be successful for the patient. CASE REPORTA 59-y-old woman with a history of rheumatoid arthritis and osteoarthritis presented with 6 mo of progressive right knee pain, which did not improve with conservative management. She had undergone cemented total-right-knee arthroplasty 2 y previously for osteoarthritis. She was previously pain-free and had not undergone recent trauma. She was afebrile and had a mildly elevated white blood cell count of 10.7 billion/L. A triple-tracer study was requested to evaluate for septic prosthesis loosening.The patient was first injected with 373.7 MBq (10.1 mCi) of 99m Tc-sulfur colloid, and spot views of the knees were obtained. The patient was then injected with 20.72 MBq (0.56 mCi) of 111 In-labeled leukocytes, and similar-projection 24-h delayed images of the knees were obtained. Lastly, the patient was injected with 862.1 MBq (23.3 mCi) of 99m Tc-methylene diphosphonate, and acquisition of dynamic flow and static blood-pool images followed immediately afterward. After 3-4 h of tracer localization, spot views of the knees were obtained.Comparison of the 99m Tc-sulfur colloid and 111 In-labeled leukocyte images (Fig. 1) did not demonstrate discordant uptake of the latter to suggest infection. On the 3-phase 99m Tc-methylene diphosphonate bone scan, there was periprosthetic hyperemia near the tibial component on the early images (Fig. 2). On the delayed images, there was increased uptake at the interface between the tibial plateau native bone and the prosthesis, worse medially (Fig. 3).The triple-tracer findings were consistent with aseptic failure of the prosthesis. Surgical exploration did not reveal any signs of infection; however, the tibial component had subsided into the medial tibial plateau and was easily

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Section: Discussionmentioning

confidence: 99%

Painful Knee Arthroplasty

Traylor

Jolepalem

Mahajan

2014

Journal of Nuclear Medicine Technology

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“…Although the results obtained were satisfactory, there are considerable, likely insurmountable, limitations to this test. The labeling efficiency of 18 F-FDG leukocytes is more variable and significantly lower than that of 111 In-oxine leukocytes (2,17). The stability of the label is poor.…”

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confidence: 97%

“…Initial attempts at developing a more specific PET tracer for infection imaging focused on labeling leukocytes in vitro with 18 F-FDG (17,18). Although the results obtained were satisfactory, there are considerable, likely insurmountable, limitations to this test.…”

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confidence: 99%

Radionuclide Imaging of Infection: In Search of the Grail

Palestro

2009

J Nucl Med

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“…[ 18 F]-FDG has routinely been used to assess tissue metabolism. As assessed by PET, reductions in glucose metabolism have been noted in Alzheimer's disease and mild cognitive impairment [17] and the hypometabolism is believed to be associated with reduced neuronal activity and neuronal loss [18,19]. If the growth retardation and altered metabolism is associated with tissue hypoxia, [ 18 F]fluoromisonidazole ([ 18 F]FMISO) [20] is a selective measure for assessing hypoxia.…”

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confidence: 99%

Could Pet Imaging Provide Insights Into Zika Virus Neurological Sequelae progression?

Smith

Bocan

2018

Future Virol.

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" An in vivo imaging approach is particularly advantageous to study progression of ZIKV-induced neurological sequelae because the development of neuropathology and congenital defects is a dynamic process. "First draft submitted: 9 November 2017; Accepted for publication: 21 November 2017; Published online: 10 January 2018Zika virus (ZIKV) is a mosquito-borne flavivirus that has emerged since 2007 causing human outbreaks in Africa, Asia, Oceania and most recently in the Americas. Mortality is not a common feature of human ZIKV infection, which is generally asymptomatic and self-limiting in most individuals. However, during the recent epidemics in Asia and the Americas, more severe clinical complications have been reported. Severe disease is characterized by neurological complications, which in adults include Guillain-Barré syndrome or in a few cases, encephalopathy, meningoencephalitis and acute myelitis [1]. ZIKV infection in pregnant women is a major global public health concern due to its link to congenital abnormalities including microcephaly, spontaneous abortion and intrauterine growth restriction [2], now referred to as congenital Zika syndrome.The unexpectedly frequent and severe clinical complications of ZIKV infection have prompted intense research on host-virus interactions, which remains a high priority research area. It is crucial that we characterize the neuropathogenesis and causative roles of ZIKV infection in the etiology of fetal microcephaly and other congenital malformations during pregnancy. Appropriate use of animal models is needed to address some of these key unanswered questions regarding the pathogenesis of ZIKV and to evaluate candidate medical countermeasures. Current approaches to study viral pathogenesis involve reduced mortality or extended time-to-death as the efficacy end point, viremia as an index of infection and serial necropsies to establish the pathological consequences of infection. New technology in the form of molecular imaging tools shifts the classical paradigm of serial necropsies and offers less invasive alternatives capable of providing a dynamic assessment of pathogen infection in real time. An in vivo imaging approach is particularly advantageous to study progression of ZIKV-induced neurological sequelae because the development of neuropathology and congenital defects is a dynamic process. While molecular imaging has been used to characterize disease progression and evaluate drugs in the areas of neuroscience, cardiovascular, inflammation and oncology, application of imaging in infectious disease is limited [3].We recently described the ability and sensitivity of PET imaging using [ 18 F]DPA-714, a translocator protein (TSPO) 18 kDa radioligand, to detect and quantify neuroinflammation in ZIKV-infected mice [4]. Our results demonstrated that global neuroinflammation plays an important role in the progression of ZIKV infection in a transiently immunosuppressed mouse model [5]. Importantly, the use of [18 F]DPA-714 PET imaging was more sensitive compared with standard...

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PET with FDG-labeled Leukocytes versus Scintigraphy with¹¹¹In-Oxine–labeled Leukocytes for Detection of Infection

Abstract: PET with FDG-labeled leukocytes was comparable to scintigraphy with (111)In-oxine-labeled leukocytes. Further investigation in a larger population with dedicated PET or PET/computed tomography seems warranted.

Cited by 86 publications

References 8 publications

Painful Knee Arthroplasty

Painful Knee Arthroplasty

Radionuclide Imaging of Infection: In Search of the Grail

Could Pet Imaging Provide Insights Into Zika Virus Neurological Sequelae progression?

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PET with FDG-labeled Leukocytes versus Scintigraphy with111In-Oxine–labeled Leukocytes for Detection of Infection

Abstract: PET with FDG-labeled leukocytes was comparable to scintigraphy with (111)In-oxine-labeled leukocytes. Further investigation in a larger population with dedicated PET or PET/computed tomography seems warranted.

Cited by 86 publications

References 8 publications

Painful Knee Arthroplasty

Painful Knee Arthroplasty

Radionuclide Imaging of Infection: In Search of the Grail

Could Pet Imaging Provide Insights Into Zika Virus Neurological Sequelae progression?

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Product

Resources

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PET with FDG-labeled Leukocytes versus Scintigraphy with¹¹¹In-Oxine–labeled Leukocytes for Detection of Infection