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[A clinical comparison between 111In labeled leukocyte and 67Ga scintigraphy in acute and chronic inflammatory
Insights
111In labeled leukocyte scintigraphy (ILLS) demonstrated higher sensitivity for suppurative foci compared to 67Ga scintigraphy (67Ga). ILLS showed distinct central accumulation patterns in lesions, aiding inflammation diagnosis.
Area of Science:
- Nuclear Medicine
- Diagnostic Imaging
- Inflammation Detection
Background:
- Inflammation diagnosis relies on various methods, including imaging techniques.
- Distinguishing between acute and chronic inflammatory conditions is crucial for effective treatment.
Purpose of the Study:
- To compare the diagnostic performance of 111In labeled leukocyte scintigraphy (ILLS) and 67Ga scintigraphy (67Ga) in patients with suspected inflammation.
- To evaluate the sensitivity and specificity of both imaging modalities for detecting infectious and suppurative foci.
Main Methods:
- 56 patients with suspected inflammation underwent both ILLS and 67Ga scintigraphy.
- Diagnosis confirmation was based on cultures, autopsy, radiography, and clinical course.
- Sensitivity and specificity for infectious and suppurative foci were calculated for both techniques.
Main Results:
- ILLS showed 60.5% sensitivity and 78.6% specificity for infectious foci, while 67Ga had 94.7% sensitivity and 47.6% specificity.
- For suppurative foci, ILLS sensitivity was 95.5% and 67Ga was 90.9%.
- ILLS exhibited central lesion accumulation, whereas 67Ga showed peripheral "doughnut" patterns.
Conclusions:
- ILLS is a sensitive tool for detecting suppurative foci, with distinct accumulation patterns.
- The study highlights differences in lesion localization between ILLS and 67Ga scintigraphy.
- ILLS may be particularly useful in acute inflammation, indicated by shorter symptom duration and higher C-reactive protein levels in positive cases.
Abstract:
111In labeled leukocyte scintigraphy (ILLS) and 67Ga scintigraphy (67Ga) were carried out in 56 patients (59 studies) with clinical suspicion of acute or chronic inflammation. The diagnosis of inflammation was based on cultures, autopsy findings, radiographic studies, and clinical course. The overall sensitivity and specificity to infectious foci for ILLS, considering all 80 sites studied, were 60.5%, 78.6%, and those for 67Ga were 94.7%, 47.6%. As to suppurative foci, sensitivity of ILLS and 67Ga were 95.5% and 90.9%. The duration from the onset of clinical symptoms to examination in patients with positive ILLS were significantly (p less than 0.005) shorter than in patients with negative ILLS. Also the C-reactive protein levels in patients with positive ILLS were significantly (p less than 0.05) higher than in patients with negative ILLS. Different accumulation patterns between ILLS and 67Ga were shown in 17 foci out of 21 lesions. ILLS tended to accumulate to the center of lesions strongly. On the other hand, 67Ga tended to concentrate peripherally like doughnut pattern.
