Labeled granulocyte scanning for the diagnosis of infected necrosis in acute pancreatitis: what kind of labeling should be used?
Identifieur interne : 004381 ( Main/Exploration ); précédent : 004380; suivant : 004382Labeled granulocyte scanning for the diagnosis of infected necrosis in acute pancreatitis: what kind of labeling should be used?
Auteurs : RBID : pubmed:8740406English descriptors
- KwdEn :
- Acute Disease, Aged, Female, Granulocytes, Humans, Indium Radioisotopes, Isotope Labeling (methods), Male, Middle Aged, Necrosis (complications), Necrosis (radionuclide imaging), Organometallic Compounds, Organotechnetium Compounds, Oximes, Oxyquinoline (analogs & derivatives), Pancreatitis (pathology), Pancreatitis (radionuclide imaging), Sensitivity and Specificity, Sepsis (complications), Sepsis (radionuclide imaging), Technetium Tc 99m Exametazime.
- MESH :
- chemical , analogs & derivatives : Oxyquinoline.
- chemical : Indium Radioisotopes, Organometallic Compounds, Organotechnetium Compounds, Oximes, Technetium Tc 99m Exametazime.
- complications : Necrosis, Sepsis.
- methods : Isotope Labeling.
- pathology : Pancreatitis.
- radionuclide imaging : Necrosis, Pancreatitis, Sepsis.
- Acute Disease, Aged, Female, Granulocytes, Humans, Male, Middle Aged, Sensitivity and Specificity.
Abstract
Clinical and laboratory data or imaging results cannot provide a positive diagnosis of septic complications of pancreatic and peripancreatic necrosis in patients with acute pancreatitis. Confirmation can be obtained only after percutaneous computed tomography (CT)-guided aspiration of the necrotic tissues or fluid collection; although the important role of 99Tc(m)-HMPAO-labeled granulocyte scintigraphy has been recently emphasized. The aim of this study was to determine the sensitivity and specificity of 99m-technetium-hexamethylpropyleneamine oxime (99Tc(m)-HMPAO)- or 111In-oxine-labeled granulocyte scintigraphy for the diagnosis of infection in pancreatic or peripancreatic necrosis to define the ideal label for diagnosis. Thirty-six scintigraphic examinations were performed in 34 consecutive patients (mean age, 58 +/- 2 years) 20 +/- 2 days after the onset of acute pancreatitis (Balthazar classes A-C, n = 7; classes D and E, n = 29). The scintigraphic study included scintigraphic tomography and static acquisition 1 and 3 h, respectively, after reinjection of the autologous 99Tc(m)-labeled granulocytes and static images 3-4 and 24 h after the simultaneous reinjection of 111In-oxine-labeled autologous granulocytes. The diagnosis of infected pancreatic or peripancreatic necrosis was confirmed with percutaneous CT-guided aspiration (14 positive aspirates among 20 performed) and sterile necrosis after negative aspiration (6 negative aspirates) or after a 6 +/- 1-month follow-up free of clinical or biological signs of ongoing sepsis. The sensitivity and specificity were 86 and 73%, respectively, for scintigraphic tomography, 100 and 55% for 3-h 111In images, 93 and 68% for 3-4-h 111In images, and 100 and 64% for 24-h 111In images. The fall in splenic activity between the 3-4 and the 24-h 111In images was 26 +/- 3% in patients with septic pancreatic and peripancreatic necrosis (n = 14) and 16 +/- 3% in those with sterile necrosis (n = 22) (p < 0.01). Labeled granulocyte scintigraphy was thus shown to be an effective tool for the diagnosis of infection in pancreatic and/or peripancreatic necrosis due to acute pancreatitis, especially when the scintiscans are performed early after injection of 99Tc(m) or when the fall in splenic activity over the 24 h following reinjection of 111In is measured in particularly difficult cases. These promising preliminary results should be confirmed by a prospective study.
PubMed: 8740406
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Labeled granulocyte scanning for the diagnosis of infected necrosis in acute pancreatitis: what kind of labeling should be used?</title><author><name sortKey="Heresbach, D" uniqKey="Heresbach D">D Heresbach</name><affiliation wicri:level="1"><nlm:affiliation>Service d'Hépatogastroentérologie et d'Assistance Nutritive, CHRU Pontchaillou, Rennes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Hépatogastroentérologie et d'Assistance Nutritive, CHRU Pontchaillou, Rennes</wicri:regionArea><placeName><region type="région">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Devillers, A" uniqKey="Devillers A">A Devillers</name></author><author><name sortKey="Rabot, A" uniqKey="Rabot A">A Rabot</name></author><author><name sortKey="Moisan, A" uniqKey="Moisan A">A Moisan</name></author><author><name sortKey="Malledant, Y" uniqKey="Malledant Y">Y Malledant</name></author><author><name sortKey="Bourguet, P" uniqKey="Bourguet P">P Bourguet</name></author><author><name sortKey="Bretagne, J F" uniqKey="Bretagne J">J F Bretagne</name></author><author><name sortKey="Gosselin, M" uniqKey="Gosselin M">M Gosselin</name></author></titleStmt><publicationStmt><date when="1996">1996</date><idno type="RBID">pubmed:8740406</idno><idno type="pmid">8740406</idno><idno type="wicri:Area/Main/Corpus">004673</idno><idno type="wicri:Area/Main/Curation">004673</idno><idno type="wicri:Area/Main/Exploration">004381</idno></publicationStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute Disease</term><term>Aged</term><term>Female</term><term>Granulocytes</term><term>Humans</term><term>Indium Radioisotopes</term><term>Isotope Labeling (methods)</term><term>Male</term><term>Middle Aged</term><term>Necrosis (complications)</term><term>Necrosis (radionuclide imaging)</term><term>Organometallic Compounds</term><term>Organotechnetium Compounds</term><term>Oximes</term><term>Oxyquinoline (analogs & derivatives)</term><term>Pancreatitis (pathology)</term><term>Pancreatitis (radionuclide imaging)</term><term>Sensitivity and Specificity</term><term>Sepsis (complications)</term><term>Sepsis (radionuclide imaging)</term><term>Technetium Tc 99m Exametazime</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Oxyquinoline</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Indium Radioisotopes</term><term>Organometallic Compounds</term><term>Organotechnetium Compounds</term><term>Oximes</term><term>Technetium Tc 99m Exametazime</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Necrosis</term><term>Sepsis</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Isotope Labeling</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Pancreatitis</term></keywords><keywords scheme="MESH" qualifier="radionuclide imaging" xml:lang="en"><term>Necrosis</term><term>Pancreatitis</term><term>Sepsis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Acute Disease</term><term>Aged</term><term>Female</term><term>Granulocytes</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Sensitivity and Specificity</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Clinical and laboratory data or imaging results cannot provide a positive diagnosis of septic complications of pancreatic and peripancreatic necrosis in patients with acute pancreatitis. Confirmation can be obtained only after percutaneous computed tomography (CT)-guided aspiration of the necrotic tissues or fluid collection; although the important role of 99Tc(m)-HMPAO-labeled granulocyte scintigraphy has been recently emphasized. The aim of this study was to determine the sensitivity and specificity of 99m-technetium-hexamethylpropyleneamine oxime (99Tc(m)-HMPAO)- or 111In-oxine-labeled granulocyte scintigraphy for the diagnosis of infection in pancreatic or peripancreatic necrosis to define the ideal label for diagnosis. Thirty-six scintigraphic examinations were performed in 34 consecutive patients (mean age, 58 +/- 2 years) 20 +/- 2 days after the onset of acute pancreatitis (Balthazar classes A-C, n = 7; classes D and E, n = 29). The scintigraphic study included scintigraphic tomography and static acquisition 1 and 3 h, respectively, after reinjection of the autologous 99Tc(m)-labeled granulocytes and static images 3-4 and 24 h after the simultaneous reinjection of 111In-oxine-labeled autologous granulocytes. The diagnosis of infected pancreatic or peripancreatic necrosis was confirmed with percutaneous CT-guided aspiration (14 positive aspirates among 20 performed) and sterile necrosis after negative aspiration (6 negative aspirates) or after a 6 +/- 1-month follow-up free of clinical or biological signs of ongoing sepsis. The sensitivity and specificity were 86 and 73%, respectively, for scintigraphic tomography, 100 and 55% for 3-h 111In images, 93 and 68% for 3-4-h 111In images, and 100 and 64% for 24-h 111In images. The fall in splenic activity between the 3-4 and the 24-h 111In images was 26 +/- 3% in patients with septic pancreatic and peripancreatic necrosis (n = 14) and 16 +/- 3% in those with sterile necrosis (n = 22) (p < 0.01). Labeled granulocyte scintigraphy was thus shown to be an effective tool for the diagnosis of infection in pancreatic and/or peripancreatic necrosis due to acute pancreatitis, especially when the scintiscans are performed early after injection of 99Tc(m) or when the fall in splenic activity over the 24 h following reinjection of 111In is measured in particularly difficult cases. These promising preliminary results should be confirmed by a prospective study.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">8740406</PMID><DateCreated><Year>1996</Year><Month>10</Month><Day>17</Day></DateCreated><DateCompleted><Year>1996</Year><Month>10</Month><Day>17</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3177</ISSN><JournalIssue CitedMedium="Print"><Volume>12</Volume><Issue>4</Issue><PubDate><Year>1996</Year><Month>May</Month></PubDate></JournalIssue><Title>Pancreas</Title><ISOAbbreviation>Pancreas</ISOAbbreviation></Journal><ArticleTitle>Labeled granulocyte scanning for the diagnosis of infected necrosis in acute pancreatitis: what kind of labeling should be used?</ArticleTitle><Pagination><MedlinePgn>381-7</MedlinePgn></Pagination><Abstract><AbstractText>Clinical and laboratory data or imaging results cannot provide a positive diagnosis of septic complications of pancreatic and peripancreatic necrosis in patients with acute pancreatitis. Confirmation can be obtained only after percutaneous computed tomography (CT)-guided aspiration of the necrotic tissues or fluid collection; although the important role of 99Tc(m)-HMPAO-labeled granulocyte scintigraphy has been recently emphasized. The aim of this study was to determine the sensitivity and specificity of 99m-technetium-hexamethylpropyleneamine oxime (99Tc(m)-HMPAO)- or 111In-oxine-labeled granulocyte scintigraphy for the diagnosis of infection in pancreatic or peripancreatic necrosis to define the ideal label for diagnosis. Thirty-six scintigraphic examinations were performed in 34 consecutive patients (mean age, 58 +/- 2 years) 20 +/- 2 days after the onset of acute pancreatitis (Balthazar classes A-C, n = 7; classes D and E, n = 29). The scintigraphic study included scintigraphic tomography and static acquisition 1 and 3 h, respectively, after reinjection of the autologous 99Tc(m)-labeled granulocytes and static images 3-4 and 24 h after the simultaneous reinjection of 111In-oxine-labeled autologous granulocytes. The diagnosis of infected pancreatic or peripancreatic necrosis was confirmed with percutaneous CT-guided aspiration (14 positive aspirates among 20 performed) and sterile necrosis after negative aspiration (6 negative aspirates) or after a 6 +/- 1-month follow-up free of clinical or biological signs of ongoing sepsis. The sensitivity and specificity were 86 and 73%, respectively, for scintigraphic tomography, 100 and 55% for 3-h 111In images, 93 and 68% for 3-4-h 111In images, and 100 and 64% for 24-h 111In images. The fall in splenic activity between the 3-4 and the 24-h 111In images was 26 +/- 3% in patients with septic pancreatic and peripancreatic necrosis (n = 14) and 16 +/- 3% in those with sterile necrosis (n = 22) (p < 0.01). Labeled granulocyte scintigraphy was thus shown to be an effective tool for the diagnosis of infection in pancreatic and/or peripancreatic necrosis due to acute pancreatitis, especially when the scintiscans are performed early after injection of 99Tc(m) or when the fall in splenic activity over the 24 h following reinjection of 111In is measured in particularly difficult cases. These promising preliminary results should be confirmed by a prospective study.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Heresbach</LastName><ForeName>D</ForeName><Initials>D</Initials><Affiliation>Service d'Hépatogastroentérologie et d'Assistance Nutritive, CHRU Pontchaillou, Rennes, France.</Affiliation></Author><Author ValidYN="Y"><LastName>Devillers</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Rabot</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Moisan</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Malledant</LastName><ForeName>Y</ForeName><Initials>Y</Initials></Author><Author ValidYN="Y"><LastName>Bourguet</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Bretagne</LastName><ForeName>J F</ForeName><Initials>JF</Initials></Author><Author ValidYN="Y"><LastName>Gosselin</LastName><ForeName>M</ForeName><Initials>M</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType>Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>UNITED STATES</Country><MedlineTA>Pancreas</MedlineTA><NlmUniqueID>8608542</NlmUniqueID><ISSNLinking>0885-3177</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance>Indium Radioisotopes</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance>Organometallic Compounds</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance>Organotechnetium Compounds</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance>Oximes</NameOfSubstance></Chemical><Chemical><RegistryNumber>100504-35-6</RegistryNumber><NameOfSubstance>Technetium Tc 99m Exametazime</NameOfSubstance></Chemical><Chemical><RegistryNumber>14514-42-2</RegistryNumber><NameOfSubstance>indium oxine</NameOfSubstance></Chemical><Chemical><RegistryNumber>5UTX5635HP</RegistryNumber><NameOfSubstance>Oxyquinoline</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N">Acute Disease</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y">Granulocytes</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Indium Radioisotopes</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Isotope Labeling</DescriptorName><QualifierName MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Necrosis</DescriptorName><QualifierName MajorTopicYN="N">complications</QualifierName><QualifierName MajorTopicYN="Y">radionuclide imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Organometallic Compounds</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Organotechnetium Compounds</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Oximes</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Oxyquinoline</DescriptorName><QualifierName MajorTopicYN="N">analogs & derivatives</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Pancreatitis</DescriptorName><QualifierName MajorTopicYN="N">pathology</QualifierName><QualifierName MajorTopicYN="Y">radionuclide imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Sensitivity and Specificity</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Sepsis</DescriptorName><QualifierName MajorTopicYN="N">complications</QualifierName><QualifierName MajorTopicYN="Y">radionuclide imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Technetium Tc 99m Exametazime</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1996</Year><Month>5</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1996</Year><Month>5</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1996</Year><Month>5</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">8740406</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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