Open AccessIntact versus Fragmented 99mTc-Monoclonal Antibody Imaging of Infection in Patients with Septically Loosened Total Knee Arthroplasty
Author(s) -
S. Gratz,
P. Reize,
Andreas Pfestroff,
H. Höffken
Publication year - 2012
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/147323001204000412
Subject(s) - medicine , immunoscintigraphy , prosthesis , scintigraphy , nuclear medicine , technetium 99m , septic arthritis , arthroplasty , bone infection , synovial fluid , prospective cohort study , technetium , total knee arthroplasty , antibody , monoclonal antibody , osteomyelitis , surgery , pathology , osteoarthritis , arthritis , immunology , alternative medicine , radioimmunotherapy
OBJECTIVE: This prospective study compared the diagnostic accuracy of imaging using an intact murine antigranulocyte antibody 99m Tc-besilesomab, and a murine antibody Fab' fragment 99m Tc-sulesomab, in patients with suspected septically loosened total knee arthroplasty. METHODS: Images from 20 patients who underwent three-phase bone scintigraphy followed by imaging using 99m Tc-besilesomab ( n = 10) or 99m Tc-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. RESULTS: Prosthesis infection was shown in 18 patients. At 4 and 24 h after intravenous injection, absolute uptake of 99m Tc-besilesomab was significantly higher than 99m Tc-sulesomab in infected knee joints. Infected-to-healthy knee activity ratios were similar at 4 and 24 h for 99m Tc-besilesomab and 99m Tc-sulesomab. CONCLUSIONS: Both 99m Tc-besilesomab and 99m Tc-sulesomab had similar diagnostic accuracy for the detection of septic arthroplasty. If repeated use of immunoscintigraphy is needed for follow-up, 99m Tc-sulesomab should be preferred over 99m Tc-besilesomab since it is known to be well tolerated and without side effects or incompatibility reactions.