Detection of acute inflammation with 111In-labeled nonspecific polyclonal IgG.

Abstract

The detection of focal sites of inflammation is an integral part of the clinical evaluation of the febrile patient. When anatomically distinct abscesses are present, lesion detection can be accomplished by standard radiographic techniques, particularly in patients with normal anatomy. At the phlegmon stage, however, and in patients who have undergone surgery, these techniques are considerably less effective. While radionuclide methods, such as Gallium-67 (67Ga)-citrate and Indium-111 (111In)-labeled WBCs have been relatively successful for the detection of early inflammation, neither approach is ideal. In the course of studies addressing the use of specific organism-directed antibodies for imaging experimental infections in animals, we observed that nonspecific polyclonal immunoglobulin G (IgG) localized as well as specific antibodies. Preliminary experiments suggested that the Fc portion of IgG is necessary for effective inflammation localization. Since polyclonal IgG in gram quantities has been safely used for therapy in patients with immune deficiency states, we decided to test whether milligram quantities of radiolabeled IgG could image focal sites of inflammation in humans. Thus far, we have studied a series of 84 patients with suspected lesions in the abdomen, pelvis, vascular grafts, lungs, or bones/joints. In 48 of 52 patients with focal lesions detected by surgery, computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound (US), the IgG scan correctly localized the site, while 31 patients without focal inflammation had no abnormal focal localization of the radiopharmaceutical. Four patients had false negative scans and one patient had a false positive scan. For this small series, the overall sensitivity and specificity were 92% and 95%, respectively. In this report, we review our experience with this exciting new agent.

Statistics

0200400600'92'95'98'01'04'07'10'13'16
Citations per Year

1,002 Citations

Semantic Scholar estimates that this publication has 1,002 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Fischman1988DetectionOA, title={Detection of acute inflammation with 111In-labeled nonspecific polyclonal IgG.}, author={Alan J. Fischman and Robert H. Rubin and Ban An Khaw and Ronald J. Callahan and Robert A. Wilkinson and Frances K. Keech and M A Nedelman and Stephen C Dragotakes and Pf Kramer and Glenn M. Lamuraglia}, journal={Seminars in nuclear medicine}, year={1988}, volume={18 4}, pages={335-44} }