Intact versus Fragmented 99m Tc-Monoclonal Antibody Imaging of Infection in Patients with Septically Loosened Total Knee Arthroplasty

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...

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Bibliographic Details
Published in:Journal of international medical research 2012-08, Vol.40 (4), p.1335-1342
Main Authors: Gratz, S, Reize, P, Pfestroff, A, Höffken, H
Format: Article
Language:English
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Summary: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.
ISSN:0300-0605
1473-2300
DOI:10.1177/147323001204000412