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(99m)Tc-Fab' fragments (sulesomab) for imaging septically loosened total knee arthroplasty
The diagnostic accuracy of infection scintigraphy with (99m)Tc-labelled monoclonal antibody Fab' fragments (sulesomab) was studied in patients with suspected total knee arthroplasty (TKA) infection. Images from 26 patients were evaluated by two independent readers and compared with a quantitati...
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| Published in: | Journal of international medical research 2009-01, Vol.37 (1), p.54-67 |
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| container_end_page | 67 |
| container_issue | 1 |
| container_start_page | 54 |
| container_title | Journal of international medical research |
| container_volume | 37 |
| creator | Gratz, S Behr, T M Reize, P Pfestroff, A Kampen, W U Höffken, H |
| description | The diagnostic accuracy of infection scintigraphy with (99m)Tc-labelled monoclonal antibody Fab' fragments (sulesomab) was studied in patients with suspected total knee arthroplasty (TKA) infection. Images from 26 patients were evaluated by two independent readers and compared with a quantitative interpretation of time-activity courses. Microbiological examinations and joint aspiration results were used as reference standards. Histologically, aseptic TKA loosening occurred in two patients and severe, moderate or mild septic loosening in four, nine and 11 patients, respectively. Diagnostic accuracy for severe infection was 100% for both readers, whereas for moderate infection accuracy decreased by 12% and 12% for readers one and two, respectively. For mild infection a further decrease of approximately 61% and 52% occurred for readers one and two, respectively. Quantitative evaluation gave significantly better results over visual interpretation with a diagnostic accuracy of 100% for severe infection and decreased by only 10% and 15% in patients with moderate and mild infection, respectively. Quantitative evaluation of (99m)Tc-Fab' fragments is highly sensitive and specific for diagnostic imaging of infection in patients with septically-loosened TKA. |
| doi_str_mv | 10.1177/147323000903700107 |
| format | article |
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Images from 26 patients were evaluated by two independent readers and compared with a quantitative interpretation of time-activity courses. Microbiological examinations and joint aspiration results were used as reference standards. Histologically, aseptic TKA loosening occurred in two patients and severe, moderate or mild septic loosening in four, nine and 11 patients, respectively. Diagnostic accuracy for severe infection was 100% for both readers, whereas for moderate infection accuracy decreased by 12% and 12% for readers one and two, respectively. For mild infection a further decrease of approximately 61% and 52% occurred for readers one and two, respectively. Quantitative evaluation gave significantly better results over visual interpretation with a diagnostic accuracy of 100% for severe infection and decreased by only 10% and 15% in patients with moderate and mild infection, respectively. Quantitative evaluation of (99m)Tc-Fab' fragments is highly sensitive and specific for diagnostic imaging of infection in patients with septically-loosened TKA.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibodies, Monoclonal - immunology</subject><subject>Antibodies, Monoclonal, Murine-Derived</subject><subject>Arthroplasty, Replacement, Knee</subject><subject>Female</subject><subject>Humans</subject><subject>Immunoglobulin Fab Fragments - immunology</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Sepsis - complications</subject><subject>Sepsis - diagnosis</subject><subject>Sepsis - immunology</subject><subject>Sepsis - microbiology</subject><subject>Staphylococcal Infections - complications</subject><subject>Staphylococcal Infections - diagnosis</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Staphylococcus - physiology</subject><subject>Substrate Specificity</subject><subject>Technetium</subject><issn>0300-0605</issn><issn>1473-2300</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNo1kD1PwzAURS0EoqXwBxiQJ2iHgJ04djyiigJSJZaysETP8XMJOB_EztB_TyvKdKWjoyvdS8g1Z_ecK_XAhcrSjDGmWaYY40ydkOkBJgd6SqZsHwmTLJ-QixC-GBOpzNNzMuE65blUYko-5lo3i02VrMDcUTfAtsE2BjoPo8fQNWAW1HUDrRvY1u2WBuxjXYH3O-q7LmCLlsYugqffLSKFIX4OXe8hxN0lOXPgA14dc0beV0-b5Uuyfnt-XT6uk56nIiacY1FICYVRqrLGatQaKgtcWi5BZCJ36HLjikIYW6jCmQxQGCE0d9xyyGbk9q-3H7qfEUMsmzpU6D202I2hlFKneSrkXrw5iqNp0Jb9sF817Mr_N7JfWsRigQ</recordid><startdate>200901</startdate><enddate>200901</enddate><creator>Gratz, S</creator><creator>Behr, T M</creator><creator>Reize, P</creator><creator>Pfestroff, A</creator><creator>Kampen, W U</creator><creator>Höffken, H</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200901</creationdate><title>(99m)Tc-Fab' fragments (sulesomab) for imaging septically loosened total knee arthroplasty</title><author>Gratz, S ; Behr, T M ; Reize, P ; Pfestroff, A ; Kampen, W U ; Höffken, H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p124t-11e8866a8b77cdbd9e99acda16d16a4345fef5bf884bd878fb3ae4b4491f1d1a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antibodies, Monoclonal - immunology</topic><topic>Antibodies, Monoclonal, Murine-Derived</topic><topic>Arthroplasty, Replacement, Knee</topic><topic>Female</topic><topic>Humans</topic><topic>Immunoglobulin Fab Fragments - immunology</topic><topic>Knee Joint - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Sepsis - complications</topic><topic>Sepsis - diagnosis</topic><topic>Sepsis - immunology</topic><topic>Sepsis - microbiology</topic><topic>Staphylococcal Infections - complications</topic><topic>Staphylococcal Infections - diagnosis</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Staphylococcus - physiology</topic><topic>Substrate Specificity</topic><topic>Technetium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gratz, S</creatorcontrib><creatorcontrib>Behr, T M</creatorcontrib><creatorcontrib>Reize, P</creatorcontrib><creatorcontrib>Pfestroff, A</creatorcontrib><creatorcontrib>Kampen, W U</creatorcontrib><creatorcontrib>Höffken, H</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of international medical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gratz, S</au><au>Behr, T M</au><au>Reize, P</au><au>Pfestroff, A</au><au>Kampen, W U</au><au>Höffken, H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>(99m)Tc-Fab' fragments (sulesomab) for imaging septically loosened total knee arthroplasty</atitle><jtitle>Journal of international medical research</jtitle><addtitle>J Int Med Res</addtitle><date>2009-01</date><risdate>2009</risdate><volume>37</volume><issue>1</issue><spage>54</spage><epage>67</epage><pages>54-67</pages><issn>0300-0605</issn><eissn>1473-2300</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>The diagnostic accuracy of infection scintigraphy with (99m)Tc-labelled monoclonal antibody Fab' fragments (sulesomab) was studied in patients with suspected total knee arthroplasty (TKA) infection. Images from 26 patients were evaluated by two independent readers and compared with a quantitative interpretation of time-activity courses. Microbiological examinations and joint aspiration results were used as reference standards. Histologically, aseptic TKA loosening occurred in two patients and severe, moderate or mild septic loosening in four, nine and 11 patients, respectively. Diagnostic accuracy for severe infection was 100% for both readers, whereas for moderate infection accuracy decreased by 12% and 12% for readers one and two, respectively. For mild infection a further decrease of approximately 61% and 52% occurred for readers one and two, respectively. Quantitative evaluation gave significantly better results over visual interpretation with a diagnostic accuracy of 100% for severe infection and decreased by only 10% and 15% in patients with moderate and mild infection, respectively. Quantitative evaluation of (99m)Tc-Fab' fragments is highly sensitive and specific for diagnostic imaging of infection in patients with septically-loosened TKA.</abstract><cop>England</cop><pmid>19215674</pmid><doi>10.1177/147323000903700107</doi><tpages>14</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Antibodies, Monoclonal - immunology Antibodies, Monoclonal, Murine-Derived Arthroplasty, Replacement, Knee Female Humans Immunoglobulin Fab Fragments - immunology Knee Joint - surgery Male Middle Aged Sepsis - complications Sepsis - diagnosis Sepsis - immunology Sepsis - microbiology Staphylococcal Infections - complications Staphylococcal Infections - diagnosis Staphylococcal Infections - microbiology Staphylococcus - physiology Substrate Specificity Technetium |
| title | (99m)Tc-Fab' fragments (sulesomab) for imaging septically loosened total knee arthroplasty |
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