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Clinical Comparison of Indium-111 Acetylacetone and Indium-111 Tropolone Granulocytes

The Nuclear Medicine Division and The Department of Radiology, Indiana University School of Medicine
Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana

Correspondence: For reprints contact: Donald S. Schauwecker, PhD, MD, VAMC (115), 1481 West Tenth St., Indianapolis, IN 46202.

ABSTRACT

This clinical study compares the efficacy of two ¹¹¹In white blood cells preparations. Seventy-six patients were imaged after an injection of granulocytes (GRAN) isolated on a Ficoll-Hypaque gradient and labeled with [¹¹¹In]acetylacetone(ACAC) in saline; 105 patients were imaged after an injection of GRAN isolated on a metrizamide-plasma gradient and labeled with [¹¹¹]tropolone (TROP) in plasma. Early (2–4 hr), intermediate (4–6 hr), and delayed (24 hr) images were obtained. The specificity was quite high (94–100%) in both preparations and no statistical differences could be found. The sensitivity for ACAC-GRAN for the early, intermediate, and delayed images were 39%, 63%, and 64%, respectively; for TROP-GRAN it was 80%, 89%, and 92%, respectively. In all cases the TROP-GRAN images were significantly more sensitive than the ACAC-GRAN images obtained at the same time after injection (p <0.001 for early and delayed images, 0.01 < p <0.025 for intermediate images). For ACAC-GRAN the intermediate and delayed images were significantly more sensitive than the early images, while no significant difference could be found for TROP-GRAN. In a blinded experiment, the ability of TROP-GRAN to demonstrate a lesion was compared to that of ACAC-GRAN. TROP-GRAN demonstrated the lesions better than ACAC-GRAN, both in the early and late images (p <0.001). TROP-GRAN visualization scores at 4–6hr equaled those obtained 24 hr after injection. In conclusion, GRAN separated and labeled in plasma with TROP are superior to those separated and labeled in saline with ACAC in three ways: (a) higher visualization scores, (b) earlier visualization of the lesion, and (c) greater sensitivity.