111In-oxine labelled leukocyte scintigraphy in the detection and localization of active inflammation and sepsis

Indium-111-oxine labelled leukocyte scintigraphy is a diagnostic technique which has recently become available for clinic evaluation within Australia. The technique was used to assess patients with suspected sepsis of inflammation after other commonly used investigations had failed to confirm a diagnosis. Four patient subgroups were evaluated: fever of unknown origin suspected abdominal or postoperative sepsis; suspected active inflammatory bowel disease; and suspected sepsis or inflammation of bones or joints. The course of all patients was followed for at least three months to establish the accuracy of the technique. The leukocyte labelling procedure took 90 min and imaging was carried out typically 3-6, 24 and occasionally 48 h after reinjection of the labelled leukocytes. Only in one patient labelling of leukocytes was unsuccessful. In the remaining 99 studies, the overall sensitivity of leukocyte scintigraphy was 88% (36 of 41 patients with a proved inflammatory or infective disease focus had positive scan findings);and the specificity was 95% (55 of 58 cases with no proved disease focus had normal scan findings). These results support the use of this method in nuclear medicine for the evaluation of suspected acute sepsis (symptoms less than four weeks' duration), of inflammatory bowel disease and of suspected infections involving appendicular bones which contain no active bone marrow. It is also a useful secondary scintigraphic procedure, after gallium-67-citrate scintigraphy, in patients with suspected infective disorders of more than four weeks' duration. 27 refs., 2 tabs., 5 figs