Detection of infection in postoperative orthopedic patients with technetium-99m-labeled monoclonal antibodies against granulocytes
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P Reuland1, K H Winker, T Heuchert
1Department of Nuclear Medicine, University of Tübingen, Germany.
Abstract:
A prospective study of 106 orthopedic patients was performed for the detection of infection in the early postoperative stage using 99mTc-labeled murine Mabs directed against epitopes on granulocytes. Accuracy was 81% in the hips (n = 26), 81% in the thigh (n = 21), 84% in the knee (n = 19), and 100% in the tibia (n = 27). The technique did not work well in the spine where false-negative results were observed in the three patients studied. One patient suffered transient swelling of the eyelids following injection. Optimal imaging results were obtained 2-6 hr postinjection.
Insights
This study shows that technetium-99m-labeled murine monoclonal antibodies (99mTc-Mabs) are effective for detecting early postoperative orthopedic infections, particularly in the lower extremities. However, the technique showed limitations in spinal imaging.
Area of Science:
- Nuclear medicine
- Immunoscintigraphy
- Orthopedic surgery
Background:
- Early detection of postoperative orthopedic infections is crucial for patient outcomes.
- Conventional diagnostic methods may have limitations in identifying subtle or early-stage infections.
Purpose of the Study:
- To evaluate the accuracy of 99mTc-labeled murine monoclonal antibodies (99mTc-Mabs) for detecting early postoperative infections in orthopedic patients.
Main Methods:
- A prospective study involving 106 orthopedic patients.
- Utilized 99mTc-labeled murine Mabs targeting granulocyte epitopes for infection detection.
- Assessed imaging results at 2-6 hours postinjection.
Main Results:
- High accuracy rates were observed in the hips (81%), thigh (81%), knee (84%), and tibia (100%).
- The technique demonstrated poor performance in spinal imaging, with false-negative results in three patients.
- One patient experienced transient eyelid swelling postinjection.
Conclusions:
- 99mTc-Mabs show significant potential for diagnosing early postoperative orthopedic infections, especially in appendicular sites.
- Further refinement is needed for spinal infection detection using this immunoscintigraphy technique.