Clinical validation of the avidin/indium-111 biotin approach for imaging infection/inflammation in orthopaedic patients

Elena Lazzeri, Mario Manca, Nicola Molea, Stefano Marchetti, Vincenzo Consoli, Lisa Bodei, R. Bianchi, Marco Chinol, Giovanni Paganelli, Giuliano Mariani

Research output: Contribution to journalArticle

Abstract

We report here the results of a validation study of the avidin/indium-111 biotin approach in patients with skeletal lesions. This study involved 54 patients with orthopaedic conditions: 20 patients with intermediate suspected osteomyelitis of the trunk, 19 patients with infection/inflammation of prosthetic joint replacements, and 15 patients with suspected osteomyelitis of appendicular bones. Avidin (3 mg) was injected as an i.v. bolus, followed 4 h later by 111In-biotin; imaging was acquired 30 min and 16-18 h after administration of 111In-biotin. Technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO)-labelled leucocyte scintigraphy was performed in 39/54 patients. The overall sensitivity of the avidin/111In-biotin scan was 97.7% (versus 88.9% for 99mTc-HMPAO leucocyte scintigraphy). While the diagnostic performance of avidin/111In biotin scintigraphy was similar to that of 99mTc-HMPAO leucocyte scintigraphy in patients with prosthetic joint replacements or osteomyelitis of appendicular bones, the avidin/111In-biotin approach clearly performed better than 99mTc-HMPAO leucocyte scintigraphy in patients with suspected osteomyelitis of the trunk (100% sensitivity, specificity and accuracy versus 50% sensitivity, 100% specificity and 66.7% accuracy for 99mTc-HMPAO-leucocyte scintigraphy). These results demonstrate the feasibility of the avidin/111In-biotin approach for imaging sites of infection/inflammation in the clinical setting. Although no systematic advantages of avidin/111In-biotin scintigraphy were found versus 99mTc-HMPAO leucocyte scintigraphy, the newer scintigraphic method is more practicable and involves lower biological risk for the operators.

Original languageEnglish
Pages (from-to)606-614
Number of pages9
JournalEuropean Journal Of Nuclear Medicine
Volume26
Issue number6
DOIs
Publication statusPublished - 1999

Keywords

  • Avidin/streptavidin
  • Indium-III-biotin
  • Inflammation/infection
  • Orthopaedic patients
  • Scintigraphic imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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