Detection of inflammation/infection with human polyclonal immunoglobulin G labelled with 99Tcm.

Radiolabelled human polyclonal immunoglobulin G (IgG) has been successful in identifying inflammatory/infectious processes in human and animal models. We studied 71 patients with suspicion of inflammation of varied origin and location (44 of musculoskeletal location and 27 other) using 99Tcm. IgG images correctly identified 21/22 inflammatory sites of musculoskeletal origin and only 4/14 sites of soft-tissue location. Five false negative studies corresponded to granulomatous processes, three of them tuberculosis. Four false positive studies were obtained in the musculoskeletal group corresponding to three synovial tumours and a Charcot joint. No false positive results were seen in the soft tissue group. 99Tcm-IgG performs well in the identification of bone-joint lesions and rules out non-inflammatory conditions (with the important exception of tumours). The role of 99Tcm-IgG in soft-tissue inflammatory sites, especially in highly vascular organs is inferior, with a high yield of false negative studies. Granulomatous lesions probably represent situations of low or absent IgG uptake.