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A Journal on Nuclear Medicine and Molecular Imaging


A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
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  IMAGING INFECTION


The Quarterly Journal of Nuclear Medicine 1999 March;43(1):2-8

language: English

Imaging infec­tion/inflam­ma­tions. Path­o­phy­sio­log­ic ­basis and radio­phar­ma­ceu­ti­cals

Weiner R. E., Thakur M. L.*

From the Department of Diagnostic Imaging and Therapeutics University of Connecticut Health Center Farmington, CT, USA
* Department of Radiology Thomas Jefferson University Hospital Philadelphia, PA, USA


FULL TEXT  REPRINTS


Inflammation is a local­ized reac­tion in the micro­cir­cu­la­tion ­that is char­ac­ter­ized by ­fluid and leu­ko­cyte trans­port ­from the ­blood ­into the extra­cel­lu­lar tis­sues. The ­increase in ­blood ­flow and ­loss of endo­the­lial integ­rity at the ­site are par­tic­u­lar­ly impor­tant in radio­phar­ma­ceu­ti­cal deliv­ery. This alter­a­tion of the micro­vas­cu­la­ture is prob­ably the ear­li­est ­response to tis­sue inju­ry. Within ­hours of inflam­ma­tion initi­a­tion, the ­site is invad­ed ­with ­large num­bers of poly­mor­pho­nu­cle­ar leu­ko­cytes (PMN). These ­cells are led to the ­site by var­i­ous chem­o-­at­trac­tants and are ­able to con­cen­trate in the ­blood ves­sels ­near the inflam­ma­tion. Upregulation of ­three fam­i­lies of adhe­sion mole­cules, ­such as the inte­grins, immu­no­glob­u­lin super­gene and selec­tins on ­both the PMN and endo­the­lial ­cells is an essen­tial com­po­nent of ­this pro­cess. While ­both 111In and 99mTc ­labeled WBC ­have had undis­put­ed suc­cess in detect­ing infec­tions and inflam­ma­tions but ­there are sig­nif­i­cant lim­i­ta­tions. Because of ­these lim­i­ta­tions ­there ­have ­been ­many ­attempts to devel­op new ­agents ­which ­have pri­mar­i­ly tar­get­ed PMN. The radio­ac­tive ­agent can ­either ­bind to the PMN ­present at the ­site or be car­ried to the ­site ­bound to PMN. These tar­gets can be PMN-asso­ciat­ed anti­gens or recep­tors on an acti­vat­ed PMN. Four mono­clo­nal anti­bod­ies, CEA-47, BW 250/183, ­IMMU-NN3 and MCA-480 ­have ­been exam­ined exten­sive­ly for ­abscess/infec­tion detec­tion in ­humans.

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