open access

Vol 7, No 2 (2004)
Short communications
Published online: 2004-06-02
Submitted: 2012-01-23
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Screening for acute myocarditis — is scintigraphy with 99mTc-Anti-Granulocyte BW 250/183 an answer?

Alicja Hubalewska, Dariusz Dudek, Jacek Dubiel, Ewa Płaczkiewicz-Jankowska, Bohdan Huszno, Anna Staszczak, Wiesław Frasik
Nucl. Med. Rev 2004;7(2):165-169.

open access

Vol 7, No 2 (2004)
Short communications
Published online: 2004-06-02
Submitted: 2012-01-23

Abstract

BACKGROUND: Myocarditis is most often caused by Coxackie B virus, influenza viruses, and echoviruses. It is usually self-restricting and ending in full recovery, but in some patients the infection leads to congestive cardiomyopathy. It is difficult to identify patients with myocarditis using clinical criteria, laboratory tests, ECG and ultrasonography, and currently a myocardial biopsy is required to establish the diagnosis. The risk of complications, sampling error and costs of this procedure underline the need of non-invasive but sensitive methods of imaging. Several radiopharmaceuticals have been used so far to confirm inflammation: 67Ga, 99mTc-nanocolloids and 111In-leucocytes. Scintigraphy with radiolabeled autologous white blood cells (WBCs) is considered a very useful method in identifying sources of inflammation but is difficult to perform and time-consuming. AIMS: The aim of our study was to investigate whether scintigraphy with 99mTc-Anti-Granulocyte BW 250/183 antibody is a valuable diagnostic method in evaluating focal and diffuse inflammation of the heart and could therefore be suggested for use in screening for acute myocarditis.
MATERIAL AND METHODS: A two dimensional scintigraphy and SPECT mode of heart imaging with the use of 99mTc-Anti-Granulocyte antibody (740 MBq) was performed on 14 subjects (11 males and 3 females) aged 25–60 years with a positive myocardial biopsy confirming an inflammatory process in the myocardium. After i.v. administration of the tracer a 1 minute series of planar scans was performed within the first 60 minutes. Delayed static scans were performed at 1, 2, 4 and 24 hours.
RESULTS: The scintigraphic scans revealed the uptake of the tracer in the heart area in 13 patients, confirming active inflammatory process. Follow-up scintigraphy was performed 3–5 months after the first study, when the control myocardial biopsy was negative. The results of the study showed the concordance between myocardial biopsy and scintigraphy results in patients with an inflammatory process in the heart.
CONCLUSIONS: Scintigraphy with the use of 99mTc-Anti-Granulocyte seems to be a useful diagnostic method in evaluating patients with suspected myocarditis, but further studies are needed to establish its sensitivity and specificity.

Abstract

BACKGROUND: Myocarditis is most often caused by Coxackie B virus, influenza viruses, and echoviruses. It is usually self-restricting and ending in full recovery, but in some patients the infection leads to congestive cardiomyopathy. It is difficult to identify patients with myocarditis using clinical criteria, laboratory tests, ECG and ultrasonography, and currently a myocardial biopsy is required to establish the diagnosis. The risk of complications, sampling error and costs of this procedure underline the need of non-invasive but sensitive methods of imaging. Several radiopharmaceuticals have been used so far to confirm inflammation: 67Ga, 99mTc-nanocolloids and 111In-leucocytes. Scintigraphy with radiolabeled autologous white blood cells (WBCs) is considered a very useful method in identifying sources of inflammation but is difficult to perform and time-consuming. AIMS: The aim of our study was to investigate whether scintigraphy with 99mTc-Anti-Granulocyte BW 250/183 antibody is a valuable diagnostic method in evaluating focal and diffuse inflammation of the heart and could therefore be suggested for use in screening for acute myocarditis.
MATERIAL AND METHODS: A two dimensional scintigraphy and SPECT mode of heart imaging with the use of 99mTc-Anti-Granulocyte antibody (740 MBq) was performed on 14 subjects (11 males and 3 females) aged 25–60 years with a positive myocardial biopsy confirming an inflammatory process in the myocardium. After i.v. administration of the tracer a 1 minute series of planar scans was performed within the first 60 minutes. Delayed static scans were performed at 1, 2, 4 and 24 hours.
RESULTS: The scintigraphic scans revealed the uptake of the tracer in the heart area in 13 patients, confirming active inflammatory process. Follow-up scintigraphy was performed 3–5 months after the first study, when the control myocardial biopsy was negative. The results of the study showed the concordance between myocardial biopsy and scintigraphy results in patients with an inflammatory process in the heart.
CONCLUSIONS: Scintigraphy with the use of 99mTc-Anti-Granulocyte seems to be a useful diagnostic method in evaluating patients with suspected myocarditis, but further studies are needed to establish its sensitivity and specificity.
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Keywords

99mTc-Anti-Granulocyte BW 250/183 antibody; myocardial inflammation; myocarditis; scintigraphy; myocardial biopsy

About this article
Title

Screening for acute myocarditis — is scintigraphy with 99mTc-Anti-Granulocyte BW 250/183 an answer?

Journal

Nuclear Medicine Review

Issue

Vol 7, No 2 (2004)

Pages

165-169

Published online

2004-06-02

Bibliographic record

Nucl. Med. Rev 2004;7(2):165-169.

Keywords

99mTc-Anti-Granulocyte BW 250/183 antibody
myocardial inflammation
myocarditis
scintigraphy
myocardial biopsy

Authors

Alicja Hubalewska
Dariusz Dudek
Jacek Dubiel
Ewa Płaczkiewicz-Jankowska
Bohdan Huszno
Anna Staszczak
Wiesław Frasik

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