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Skeletal Scintigraphy with Technetium-99m-Tetraphenyl Porphyrin Sulfonate for the Detection and Determination of Osteomyelitis in an Animal Model

Departments of Radiology, Nuclear Section and Internal Medicine, Division of Infectious Disease, The University of Texas Medical Branch, Galveston, Texas

Correspondence: For correspondence or reprints contact: Martin L. Nusynowitz, MD, Department of Radiology, Nuclear Medicine Section 07933, 01 University Blvd., Galveston, TX 77555-0793.

ABSTRACT

This article explores the accumulation of ^99mTc-tetraphenyl porphyrin sulfonate (TPPS₄) at inflammatory sites, especially osteomyelitis, and compares the results with ¹¹¹In CI₃ and ¹¹¹In-WBC-WBCin an animal model. Methods: Osteomyelitis was induced in 12 New Zealand white rabbits by injecting staphylococcus aureus in the left tibia. Three weeks later, radiographs confirmed the disease. Two hours later, after injection of 74 MBq ^99mTc-TPPS₄, scintiphotos of the lower extremities were acquired and repeat scintiphotos were ob tained 24 hr after injection of 5.55 MBq ¹¹¹InCI₃. After these studies, 24-and 48-hr scintiphotos of the lower extremities were acquired after injecting 5.55 MBq ¹¹¹In-labeledWBC. Results: The left tibia averaged three times the uptake with ^99mTc-TPPS₄ compared with right tibia; with ¹¹¹In CI₃ and ¹¹¹In WBC the ratios are two times. These three radiopharmaceuticals reveal positive images, but the image quality using ^99mTc-TPPS₄ is better, as would be expected from the more favorable physical characteristics of ^99mTc and the higher uptake. Conclusion: The traditional combination of three-phase bone and ⁶⁷Ga-citrate scintigraphy can be replaced by a single injection of ^99mTc-TPPS₄with imaging as early as 2 hr. Finally, the use ^99mTc-TPPS₄ should result in a substantial reduction in radiopharmaceutical cost.

Key Words: osteomyelitis • technetium-99m-tetraphenyl porphyrin sulfonate • indium-111 • white blood cells