99mTc-besilesomab Scintimun® in peripheral osteomyelitis: comparison with 99mTc-labelled white blood cellsReport as inadecuate

99mTc-besilesomab Scintimun® in peripheral osteomyelitis: comparison with 99mTc-labelled white blood cells - Download this document for free, or read online. Document in PDF available to download.

European Journal of Nuclear Medicine and Molecular Imaging

, Volume 38, Issue 5, pp 899–910

First Online: 15 February 2011Received: 23 August 2010Accepted: 04 January 2011


PurposeThe diagnosis of osteomyelitis is a challenge for diagnostic imaging. Nuclear medicine procedures including white blood cell imaging have been successfully used for the identification of bone infections. This multinational, phase III clinical study in 22 European centres was undertaken to compare anti-granulocyte imaging using the murine IgG antibody besilesomab Scintimun® with Tc-labelled white blood cells in patients with peripheral osteomyelitis.

MethodsA total of 119 patients with suspected osteomyelitis of the peripheral skeleton received Tc-besilesomab and Tc-hexamethylpropyleneamine oxime HMPAO-labelled white blood cells WBCs in random order 2–4 days apart. Planar images were acquired at 4 and 24 h after injection. All scintigraphic images were interpreted in an off-site blinded read by three experienced physicians specialized in nuclear medicine, followed by a fourth blinded reader for adjudication. In addition, clinical follow-up information was collected and a final diagnosis was provided by the investigators and an independent truth panel. Safety data including levels of human anti-mouse antibodies HAMA and vital signs were recorded.

ResultsThe agreement in diagnosis across all three readers between Scintimun® and Tc-HMPAO-labelled WBCs was 0.83 lower limit of the 95% confidence interval 0.8. Using the final diagnosis of the local investigator as a reference, Scintimun® had higher sensitivity than Tc-HMPAO-labelled WBCs 74.8 vs 59.0% at slightly lower specificity 71.8 vs 79.5%, respectively. All parameters related to patient safety laboratory data, vital signs did not provide evidence of an elevated risk associated with the use of Scintimun® except for two cases of transient hypotension. HAMA were detected in 16 of 116 patients after scan 13.8%.

ConclusionScintimun® imaging is accurate, efficacious and safe in the diagnosis of peripheral bone infections and provides comparable information to Tc-HMPAO-labelled WBCs.

KeywordsOsteomyelitis Scintimun® WBC Imaging Nuclear medicine  Download fulltext PDF

Author: Wolf S. Richter - Velimir Ivancevic - Johannes Meller - Otto Lang - Dominique Le Guludec - István Szilvazi - Holger Amth

Source: https://link.springer.com/

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