Gratz S, Reize P, Pfestroff A, Höffken H
Department of Nuclear Medicine, Philipps University, Marburg, Germany.
J Int Med Res. 2012;40(4):1335-42. doi: 10.1177/147323001204000412.
This prospective study compared the diagnostic accuracy of imaging using an intact murine antigranulocyte antibody 99mTc-besilesomab, and a murine antibody Fab fragment 99mTc-sulesomab, in patients with suspected septically loosened total knee arthroplasty.
Images from 20 patients who underwent threephase bone scintigraphy followed by imaging using 99mTc-besilesomab (n=10) or 99mTc-sulesomab (n=10) were evaluated and compared. Final diagnosis was determined by microbiological evaluation of aspirated synovial fluid, intraoperative samples through the clinical course, or by long-term follow-up.
Prosthesis infection was shown in 18 patients. At 4 and 24 h after intravenous injection, absolute uptake of 99mTc-besilesomab was significantly higher than 99mTc-sulesomab in infected knee joints. Infected-to-healthy knee activity ratios were similar at 4 and 24 h for 99mTc-besilesomab and 99mTc-sulesomab.
Both 99mTc-besilesomab and 99mTc-sulesomab had similar diagnostic accuracy for the detection of septic arthroplasty. If repeated use of immunoscintigraphy is needed for follow-up, 99mTc-sulesomab should be preferred over 99mTc-besilesomab since it is known to be well tolerated and without side effects or incompatibility reactions.
本前瞻性研究比较了完整鼠抗粒细胞抗体99mTc-贝西莫单抗和鼠抗体Fab片段99mTc-舒利索单抗成像在疑似感染性全膝关节置换术患者中的诊断准确性。
对20例患者的图像进行评估和比较，这些患者先进行三相骨闪烁显像，随后使用99mTc-贝西莫单抗（n = 10）或99mTc-舒利索单抗（n = 10）进行成像。最终诊断通过对抽取的滑液进行微生物学评估、术中样本结合临床病程或长期随访来确定。
18例患者显示有假体感染。静脉注射后4小时和24小时，感染膝关节中99mTc-贝西莫单抗的绝对摄取量显著高于99mTc-舒利索单抗。99mTc-贝西莫单抗和99mTc-舒利索单抗在4小时和24小时时感染膝关节与健康膝关节的活性比值相似。
99mTc-贝西莫单抗和99mTc-舒利索单抗在检测感染性关节置换术方面具有相似的诊断准确性。如果随访需要重复使用免疫闪烁显像，99mTc-舒利索单抗应优于99mTc-贝西莫单抗，因为已知其耐受性良好，无副作用或不相容反应。
