99mTc-depreotide in the evaluation of bone infection and inflammation.
ABSTRACT (99m)Tc-depreotide is a (99m)Tc-labelled somatostatin analogue, with high affinity for the 2, 3 and 5 subtypes of somatostatin receptors. These particular receptors are over-expressed on the surface of activated leucocytes, which mediate inflammatory response. Based on this property this study tried to investigate whether (99m)Tc-depreotide scintigraphy could be a useful complementary method in the investigation of bone infection and inflammation.
Twenty-three patients, who were investigated for probable osteomyelitis, underwent three-phase bone scintigraphy followed by (99m)Tc-depreotide scintigraphy. Clinical and laboratory findings, complementary imaging procedures, clinical follow-up and bone biopsy established the final diagnosis. (99m)Tc-depreotide scintigraphy was performed 3 h after the intravenous administration of 555-740 MBq of the radiopharmaceutical. Scintigraphic images were, at first, blindly interpreted alone and then in comparative assessment with bone scans.
(99m)Tc-depreotide was positive in 12/12 cases of active osteomyelitis, one case of recent femoral head osteonecrosis and 6/9 rheumatoid arthritis sites. Negative (99m)Tc-depreotide scans were acquired in five cases of 'no-inflammation' (an uncomplicated fracture, an aseptic loosening of prosthesis, an old osteonecrosis, a healed and a successfully treated osteomyelitis), as well as in 14/14 total sites of degenerative arthritis-osteoarthropathy. In five cases (septic arthritis, periodontal and soft tissue infections) (99m)Tc-depreotide was positive, though spatially discordant with bone scintigraphy, delineating precisely the focus of infection.
(99m)Tc-depreotide can be a useful complementary imaging method in the evaluation of bone infection and inflammation. Its combination with three-phase bone scintigraphy seems to be accurate in localizing the infection foci and determining the activity of the inflammatory processes.
- SourceAvailable from: Argiris Symeonidis[show abstract] [hide abstract]
ABSTRACT: We report a case of thrombotic thrombocytopenic purpura (TTP) with cardiac involvement, imaged with Tc-99m depreotide. A 56-year-old man presented with fever, hematuria, and chest pain. Laboratory findings (angiopathic hemolytic anemia, thrombocytopenia, and uremia) were suggestive of TTP. Cardiac enzymes were elevated and diffuse left ventricular hypokinesis was demonstrated by echocardiography. Serum rheumatologic and virologic analysis were negative. A Tc-99m depreotide SPECT/CT study showed diffuse uptake in the myocardium, indicating inflammatory reaction to thrombotic/hemorrhagic myocardial damage. We suggest that Tc-99m depreotide imaging may reveal myocardial involvement in TTP; this could prompt further investigation for potential applications in myocarditis of other etiologies.Clinical nuclear medicine 01/2009; 33(12):874-5. · 3.92 Impact Factor
Article: [Bone infections].[show abstract] [hide abstract]
ABSTRACT: Even in recent traumatology and orthopedic surgery infectious diseases of the bone (i.e. osteomyelitis) and it's surrounding tissues remain serious complications. The therapy is demanding and oftenly does not lead to a complete restitutio ad integrum. In order to create the optimal treatment one has to have a profound knowledge about the "state of the art" therapy of bone infections and the basic phases: Reassurance of the local infection (bone and surrounding tissues) and reconstruction of the bone and surrounding tissues. The local infection treatment is based on the consequent surgical eradication of infected tissue. In addition (as a supportive therapy) antibiotics have to be applied according to the local and systemic response of the patient to the infection. Also further supportive methods like hyperbaric oxygenation may be taken into consideration. The following paper provides an overview of diagnostic features and the different surgical procedures as well as the current literature in order to reach the above mentioned goals.Der Unfallchirurg 06/2012; 115(6):480-8. · 0.64 Impact Factor