Dams E T, Oyen W J, Boerman O C, Claessens R A, Wymenga A B, van der Meer J W, Corstens F H
Department of Nuclear Medicine, University Hospital Nijmegen, The Netherlands.
J Nucl Med. 1998 Jan;39(1):119-24.
A novel method to label polyclonal human immunoglobulin G (IgG) with 99mTc through the nicotinyl hydrazine derivative (HYNIC) has shown promising results in the detection of experimental infection. In this study, 99mTc-labeled HYNIC-IgG was directly compared to (111)In-labeled diethylenetriaminepentaacetic acid (DTPA)-IgG in patients suspected of infectious or inflammatory disease.
Thirty-seven patients (22 women and 15 men; mean age = 54 yr, range = 17-78 yr) with 39 suspected infectious or inflammatory foci were prospectively studied. After administration of 740 MBq 99mTc-HYNIC-IgG, imaging was performed at 4 and 24 hr postinjection. To avoid cross-over activity, (111)In-DTPA-IgG was injected 24 hr after 99mTc-HYNIC-IgG and imaged at 4, 24 and 48 hr postinjection. The scintigraphic results were confirmed by microbiological, histological, radiological and clinical methods.
Technetium-99m-HYNIC-IgG and (111)In-DTPA-IgG scintigraphy showed 100% concordancy. All 17 patients with proven infection or inflammation (19 foci, mainly localized in the locomotor system) had positive scintigraphic findings. No false-negative scintigrams were recorded. In three patients, the scintigrams were concordantly false-positive. As a result, the sensitivity and specificity of imaging infectious or inflammatory foci with 99mTc-HYNIC-IgG and (111)In-DTPA-IgG in these patients were 100% and 85%, respectively.
Technetium-99m-HYNIC-IgG scintigraphy is equally as effective as (111)In-IgG scintigraphy for the detection of infection and inflammation. The apparent physical and logistic advantages of 99mTc over (111)In make 99mTc-HYNIC-IgG a promising new radiopharmaceutical for imaging infection and inflammation.
一种通过烟酰肼衍生物（HYNIC）用99mTc标记多克隆人免疫球蛋白G（IgG）的新方法在实验性感染检测中显示出有前景的结果。在本研究中，将99mTc标记的HYNIC-IgG与（111）In标记的二乙三胺五乙酸（DTPA）-IgG在疑似感染性或炎性疾病的患者中进行了直接比较。
对37例患者（22例女性和15例男性；平均年龄 = 54岁，范围 = 17 - 78岁）的39个疑似感染性或炎性病灶进行前瞻性研究。给予740 MBq 99mTc-HYNIC-IgG后，在注射后4小时和24小时进行成像。为避免交叉活性，在99mTc-HYNIC-IgG注射24小时后注射（111）In-DTPA-IgG，并在注射后4小时、24小时和48小时进行成像。闪烁扫描结果通过微生物学、组织学、放射学和临床方法得到证实。
99mTc-HYNIC-IgG和（111）In-DTPA-IgG闪烁扫描显示100%一致性。所有17例经证实有感染或炎症的患者（19个病灶，主要位于运动系统）闪烁扫描结果均为阳性。未记录到假阴性闪烁图。在3例患者中，闪烁图均为一致的假阳性。因此，在这些患者中，用99mTc-HYNIC-IgG和（111）In-DTPA-IgG对感染性或炎性病灶成像的敏感性和特异性分别为100%和85%。
99mTc-HYNIC-IgG闪烁扫描在检测感染和炎症方面与（111）In-IgG闪烁扫描同样有效。99mTc相对于（111）In明显的物理和后勤优势使99mTc-HYNIC-IgG成为一种有前景的用于感染和炎症成像的新型放射性药物。
