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The Efficacy of Indium-111-Polyclonal IgG for the Detection of Infection and Inflammation

The Division of Nuclear Medicine, Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
R. W. Johnson Pharmaceutical Research Institute, Spring House, Pennsylvania

Correspondence: For correspondence or reprints contact: Frederick L. Datz, MD, Director, Div. of Nuclear Medicine, Dept. of Radiology, Room 1B-647, University of Utah School of Medicine, Salt Lake City, Utah 84132.

ABSTRACT

The purpose of this study was to determine the efficacy of ¹¹¹In-polyclonal immunoglobulin (IgG) for the diagnosis of infection or inflammation. Methods: Fifty-three patients with suspected infection were prospectively studied. Each underwent an ¹¹¹In-polyclonal IgG study; biopsy, surgery, additional nuclear medicine scans and radiographic studies were used to confirm the IgG scan results. Results: The polyclonal IgG scan had a sensitivity of 97.9% and a specificity of 94% for infection or inflammation. When only infection or severe inflammation such as bowel infarction was considered, the sensitivity remained the same but the specificity fell to 83%. Chronic infections were detected equally as well as acute infections. Antibiotics, steroids, anti-inflammatory agents, diabetes and diminished renal function did not affect scan sensitivity. There were no adverse reactions to the radiopharmaceutical. Three patients underwent extended imaging. Their scans stayed positive for an average of 8 days. Three patients treated for infection had their scans turn negative on repeat study, confirming the efficacy of their antibiotic therapy. Conclusion: Indium-111-polyclonal IgG is an effective imaging agent of infection and/or inflammation that is useful in a variety of infections and in severe inflammatory diseases. The ease of preparation and safety make it an attractive alternative to labeled leukocytes.

Key Words: ¹¹¹In polyclonal human IgG • inflammation • infection

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