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Comparison of Purified Indium-111 Granulocytes and Indium-111 Mixed Leukocytes for Imaging of Infections

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

Correspondence: For reprints contact: Donald S. Schauwecker, PhD., MD, Div. of Nuclear Medicine, Wishard Memorial Hospital, 1001 West Tenth St., Indianapolis, IN 46202.

ABSTRACT

Several methods have been proposed for the separation and labeling of white blood cells for the diagnosis of suspected infection. We retrospectively compared 105 patients imaged with ¹¹¹In purified granulocytes (GRAN) to 106 patients imaged with ¹¹¹In mixed leukocytes (MIX). We found that in acute infection the sensitivity of GRAN and MIX were both high and not statistically different. In chronic infections the sensitivities were lower than for acute infections. Again, there was no significant difference between GRAN and MIX with the borderline significant exception of MIX being superior to GRAN in chronic soft tissue infections (p = 0.06). We then had independent observers blindly grade the degree of lesion visualization. We found that delayed images visualized the lesions better than early images (p = 0.0001) and acute infection was better visualized than chronic infection (p = 0.03). We concluded that, in routine clinical practice, MIX is probably the agent of choice for three reasons: (a) easier preparation, (b) comparable sensitivity in acute infection and, (c) borderline superior sensitivity in chronic infection.

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