Nuklearmedizinische Entzündungsdiagnostik: Update 2017

Zusammenfassung

Die Szintigrafie mit radioaktiv markierten Leukozyten und Antigranulozytenantikörpern bildet den Eckpfeiler der nuklearmedizinischen Diagnostik entzündlicher und infektiöser Erkrankungen. Obwohl sich die FDG-PET/CT in der Diagnostik entzündlicher Erkrankungen in immer mehr Indikationen etabliert, bleibt die Szintigrafie mit markierten Leukozyten und Antigranulozytenantikörpern – auch wegen eingeschränkter Verfügbarkeit der FDG – bei entzündlichen Erkrankungen, die mit hoher Wahrscheinlichkeit erregerbedingt sind, die nuklearmedizinische Bildgebung der Wahl. In dieser Übersichtsarbeit werden die Entwicklung und der derzeitige Stellenwert der Leukozyten- und Antigranulozytenantikörperszintigrafie bei den wichtigsten dafür geeigneten Fragestellungen beleuchtet. Abschließend wird auch der aktuelle Kenntnisstand zum Beitrag der Hybridbildgebung SPECT/CT in der Diagnostik entzündlicher Erkrankungen wiedergegeben.

Abstract

Scintigraphy with radioactively labelled leukocytes and antigranulocyte antibodies constitutes the cornerstone of radionuclide imaging of inflammatory and infectious diseases. Although FDG-PET/CT is establishing itself more and more in diagnosing inflammatory diseases, scintigraphy with labelled leukocytes and antigranulocyte antibodies remains – also because of reduced availability of FDG − the radionuclide imaging modality of choice in inflammatory diseases which are very likely caused by pathogens. In this review the advancement and present status of labelled-leukocyte and antigranulocyte-antibody scintigraphy in the most important suitable indications is examined. Finally, the current knowledge about the contribution of hybrid imaging SPECT/CT to diagnosing inflammatory diseases is reported.

Schlüsselwörter

Markierte Leukozyten - Antigranulozytenantikörper - Szintigrafie - Hybridbildgebung - Entzündung - Infektion

Key words

Labelled leukocytes - antigranulocyte antibodies - scintigraphy - radionuclide imaging - hybrid imaging - inflammation - infection

• Literatur

• 1 Adams BK. 99mTc leukocyte scintigraphy in infective endocarditis. Clin Nucl Med 1995; 20: 395-397
• 2 Annovazzi A, Bagni B, Burroni L. et al. Nuclear medicine imaging of inflammatory/infective disorders of the abdomen. Nucl Med Commun 2005; 26: 657-664
• 3 Ascher NL, Ahrenholz DH, Simmons RL. et al. Indium 111 autologous tagged leukocytes in the diagnosis of intraperitoneal sepsis. Arch Surg. 1979; 114: 386-392
• 4 Ascher HL, Forstrom L, Simmons RL. Radiolabeled autologous leukocyte scanning in abscess detection. World J Surg 1980; 4: 395-402
• 5 Bar-Shalom R, Yefremov N, Guralnik L. et al. SPECT/CT Using 67Ga and 111In-Labeled Leukocyte Scintigraphy for Diagnosis of Infection. J Nucl Med 2006; 47: 587-594
• 6 Becker W. Differentialindikation für verschiedene radioaktive Arzneimittel bei unterschiedlichen entzündlichen Erkrankungen. Nuklearmedizin 1999; 38: 243
• 7 Becker W. Entzündungsdiagnostik mit autologen Leukozyten und murinen monoklonalen Antikörpern. Nuklearmediziner 1992; 15: 273-286
• 8 Becker W. The contribution of nuclear medicine to the patient with infection. Eur J Nucl Med 1995; 22: 1195-1211
• 9 Becker W, Borst U, Fischbach W. et al. Kinetic data of in-vivo labeled granulocytes in humans with a murine Tc-99m-labeled monoclonal antibody. Eur J Nucl Med 1989; 15: 361-366
• 10 Becker W, Dölkemeyer U, Gramatzki M. et al. Use of immunoscintigraphy in the diagnosis of fever of unknown origin. Eur J Nucl Med 1993; 20: 1078-1083
• 11 Becker W, Meller J. The role of nuclear medicine in infection and infllammation. Lancet Infectious Diseases 2001; 1: 326-333
• 12 Bennink RJ, Roelof J, Peeters M. et al. Evaluation of early treatment response and predicitng the need for colectomy in active ulcerative colitis with 99mTc-HMPAO white blood cell scintigraphy. J Nucl Med 2004; 45: 1698-1704
• 13 Berberich R, Hennes P, Alexander C. Entzündungsnachweis und HAMA-Bildung nach Applikation des monokolonalen Antikörpers BW250/183. Nuklearmedizin 1992; 31: 70-73
• 14 Biancone L, Schillaci O, Capoccetti F. et al. Technetium-99m-HMPAO labeled leukocyte single photon emission computerized tomography (SPECT) for assessing Crohnʼs disease extent and intestinal infiltration. Am J Gastroenterol 2005; 100: 344-354
• 15 Blom AW, Brown J, Taylor AH. et al. Infection after total knee arthroplasty. J Bone Joint Surg (Br) 2004; 86: 688-691
• 16 Borst U, Becker W, Maisch B. et al. Indium-111 or Tc-99m-HMPAO marked granulocytes as specific markers of florid stage endocarditis-results comparing clinical, histological and scintigraphic findings in 30 patients with suspected endocarditis. Z Kardiol 1992; 81: 432-437
• 17 Bosslet K, Lüben G, Schwarz A. et al. Immunohistochemical localization and molecular characteristics of three monoclonal antibody-defined epitopes detectable on carcinoembryonic antigen CEA). Int J Cancer 1985; 36: 75-84
• 18 Buhl T, Stentzer K, Hede A. et al. Bone infection in patients suspected of complicating osteomyelitis: the diagnostic value of dual isotope bone-granulocyte scintigraphy. Clin Physiol Funct Imaging 2005; 25: 20-26
• 19 Caobelli F, Panarotto MB, Andreoli F. et al. Is 99mTc-HMPAO granulocyte scan an alternative to endoscopy in pediatric chronic inflammatory bowel disease (IBD)?. Eur J Pediatr 2011; 170: 51-57
• 20 Capriotti G, Chianelli M, Signore A. Nuclear medicine imaging of diabetic foot infection: results of meta-analysis. Nucl Med commun 2006; 27: 757-764
• 21 Cascini GL, De Palma D, Matteucci F. et al. Fever of unknown origin, infection of subcutaneous devices, brain abscesses and endocarditis. Nucl Med Commun 2006; 27: 213-222
• 22 Cheow HK, Voutnis DD, Evans JW. et al. Quantification of disease activity in patients undergoing leucocyte scintigraphy for suspected inflammatory bowel disease. Eur J Nucl Med Mol Imaging 2005; 32: 329-337
• 23 Coleman RE, Black RE, Welch DM. et al. Indium-111 labeled leukocytes in the evaluation of suspected abdominal abscesses. Am J Surg 1980; 139: 99-104
• 24 Connolly LP, Connolly SA, Drubach LA. et al. Acute hematogenous osteomyelitis of children: assessment of skeletal scintigraphy-based diagnosis in the era of MRI. J Nucl Med 2002; 43: 1310-1316
• 25 Costa DC, Lui D, Sinha AK. et al. Intracellular localization of 99Tcm-d,l-HMPAO and 201Tl-DDC in rat brain. Nucl Med Commun 1989; 10: 459-466
• 26 Del Rosario MA, Fitzgerald JF, Siddiqui AR. et al. Clinical applications of technetium Tc 99m hexamethyl propylene amine oxime leukocyte scan in children with inflammatory bowel disease. J Pediatr Gastroenterol 1999; 28: 63-70
• 27 Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten. (federführend) Aktualisierte S3-Leitlinie Diagnostik und Therapie des M. Crohn. AWMF-Register Nr. 021-004. 2014 http://www.awmf.org
• 28 Deutsche Gesellschaft für Gefäßchirurgie. Leitlinie Gefäßinfektionen. [Online] 2008 http://www.gefaesschirurgie.de/fileadmin/websites/dgg/download/LL_Gefaessinfektionen_2011.pdf
• 29 Durak DT. Fever of unknown origin. Mackoviac PA. [Hrsg.] Fever. Basic mechanisms and management. 2nd. ed. Philadalphia: Lippincott-Raven; 1997: 237-249
• 30 Durack DT, Street AC. Fever of unknown origin - reexamined and redefined. Curr Clin Top Infect Dis 1991; 11: 35-51
• 31 Erba PA, Conti U, Lazzeri E. et al. Added Value of 99mTc-HMPAO-Labeled Leukocyte SPECT/CT in the Characterization and Management of Patients with Infectious Endocarditis. J Nucl Med 2012; 53: 1235-1243
• 32 European Medicine Agency. Leukoscan: EPAR - Product Information. [Online] 2007 http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000111/WC500036477.pdf
• 33 European Medicines Agency. Scintimun: EPAR - Product Information. [Online] 2016 http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/001045/WC500075575.pdf
• 34 Fernandez P, Monet A, Matei C. et al. 99mTc-HMPAO labelled white blood cell scintigraphy in patients with osteoarticular infection: the value of late images for diagnostic accuracy and interobserver reproducibility. Eur J Clin Microbiol Infect Dis 2008; 27: 1239-1244
• 35 Gamollón F. et al. on behalf of ECCO 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn’s Disease 2016: Part 1: Diagnosis and Medical Management. J Crohns Colitis 2017; 11: 3-25
• 36 Gemmel F, Dumarey N, Palestro CJ. Radionuclide imaging of spinal infections. Eur J Nucl Med Mol Imaging 2006; 26: 1226-1237
• 37 Glaudemans AWJM, Galli F, Pacilio M. et al. Leukocyte and bacteria imaging in prosthetic joint infection. Eur Cell Mater 2013; 25: 61-77
• 38 Gotthardt M, Bleeker-Rovers CP, Boerman OC. et al. Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques. J Nucl Med 2010; 51: 1937-1949
• 39 Gratz S, Braun HG, Behr TM. et al. Photopenia in chronic vertabral ostteomyelitis with technetium-99m-antigranulocyte antibody (BW 250/183). J Nucl Med 1997; 40: 211-216
• 40 Gratz S, Doerner J, Oestmann JW. et al. 67Ga-citrate and 99Tcm-MDP for estimating the severity of vertabral osteomyelitis. Nucl Med Commun 2000; 21: 111-120
• 41 Gratz S, Raddatz D, Hagenah G. et al. 99mTc-labelled antigrynulocyte monoclonal antibody FAB' fragments versus echocardiography in the diagnosis of subacute infective endocarditis. Int J Cardiol 2000; 75: 75-84
• 42 Gratz S, Reize P, Pfestroff A. et al. Intact versus Fragmented 99mTc-Monoclonal Antibody Imaging of Infection in Patients with Septically Loosened Total Knee Arthroplasty. J Int Med Res 2012; 40: 1335-1342
• 43 Graute V, Feist M, Lehner S. et al. Detection of low-grade prosthetic joint infections using 99mTc-antigranulocyte SPECT/CT: initial clinical results. Eur J Nucl Med Mol Imaging 2010; 37: 1751-1759
• 44 Gutfilen B, Lopes de Souza SA, Martins FPP. et al. Use of 99mTc-mononuclear leukocyte scintigraphy in nosocomial fever. Acta Radiol 2006; 47: 699-704
• 45 Hahn K, Fischer S. Zum Stellenwert der Knochenszintigraphie in der Pädiatrie. Nuklearmediziner 2002; 25: 214-224
• 46 Horsthuis K, Bipat S, Bennink RJ. et al. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology 2008; 247: 64-79
• 47 ICRP. Radiation Dose to Patients from Radiopharmaceuticals. ICRP Publication 53. Ann ICRP 1988; 18: 256
• 48 ICRP. Radiation Dose to Patients from Radiopharmaceuticals. ICRP Publication Ann ICRP 1988; 18: 323
• 49 Ivančević V. Nuklearmedizinische Entzündungsdiagnostik - Osteomyelitis. Nuklearmediziner 2007; 30: 123-131
• 50 Ivančević V, Dodig D, Livaković M. et al. Comparison of three-phase bone scan, three-phase 99m-Tc-HM-PAO leukocyte scan and 67-gallium scan in chronic bone infection. Prog Clin Biol Res 1990; 355: 189-198
• 51 Ivančević V, Munz DL. Nonspecific bowel activity in 99Tcm-labelled monoclonal anti-granulocyte-antibody imaging. Nucl Med Commun 1992; 12: 899-900
• 52 Ivančević V, Munz DL. Nuclear medicine imaging of endocarditis. Q J Nucl Med 1999; 43: 93-99
• 53 Ivančević V, Perka C, Hasart O. et al. Imaging of low-grade bone infection with technetium-99m albelled monoclonal anti-NCA-90 Fab' fragment in patients with previous joint surgery. Eur J Nucl Med 2002; 29: 547-551
• 54 Ivančević V, Wolter A, Munz DL. Nonspecific bowel activity in imaging inflammation with Tc-99m labeled monoclonal anti-NCA-90 Fab' fragment MN3. Nuklearmedizin 2001; 40: 71-74
• 55 Jutte P, Lazzeri E, Sconfienza LM. et al. Diagnostic flowcharts in Osteomyelitis, Spondylodiscitis and Prosthetic Joint Infection. Q J Nucl Med Mol Imaging 2014; 58: 2-19
• 56 Kurtz S, Mowat F, Ong K. et al. Prevalence of primary and revision total hip and knee arthroplasty in the United States trom 1999 through 2002. J Bone joint Surg 2005; 87: 1487-1497
• 57 Jaeschke R, Guyatt G, Sackett DL. Users’ guides to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA 1994; 271: 389-391
• 58 Lew DP, Waldvogel FA. Current concepts: Osteomyelitis. N Engl Med J 1997; 336: 999-1007
• 59 Litzler PY, Manrique A, Etienne M. et al. Leukocyte SPECT/CT for Detecting Infection of Left-Ventricular-Assist Devices: Preliminary Results. J Nucl Med 2010; 51: 1044-1048
• 60 Love C, Palestro CJ. Radionuclide imaging of inflammation and infection in the acute care setting. Semin Nucl Med 2013; 43: 102-113
• 61 Love C, Patel M, Lonner BS. et al. Diagnosing spinal osteomeylitis: a comparisaon of bone and Ga-67 scintigraphy and magnetic resonance imagins. Clin Nucl Med 2000; 25: 963-977
• 62 MacSweeney JE, Peters AM, Lavender JP. Indium labelled leukocyte scanning in pyrexia of unknown origin. Clin Radiol 1990; 42: 414-417
• 63 Mader JT, Shirtliff M, Calhoun JH. Staging and stagina applications in osteomyelitis. Clin Infect Dis 1997; 25: 1303-1309
• 64 McAfee JG, Thakur M. Survey of radioactive agents for in vitro labelling of phagocytic leucycytes. 1. Soluble agents. J Nucl Med 1976; 17: 145-150
• 65 Melkun ET, Lewis Jr VL. Evaluation of (111) indium-labeled autologous leukocyte scintigraphy for the diagnosis of chronic osteomyelitis in patients with grade IV pressure ulcers, as compared with a standard diagnostic protocol. Ann Plas Surg 2005; 54: 633-636
• 66 Meller B, Bähre M. Radiopharmaka für die Entzündungsdiagnostik. Nuklearmediziner 2007; 30: 95-103
• 67 Meller J. Nuklearmedizinische Entzündungsdiagnostik – Update 2007. Nuklearmediziner 2007; 30: 94-167
• 68 Meller J, Sahlmann CO, Becker W. Nuclear medicine studies in the dialysis patient. Semin Dial 2002; 15: 269-276
• 69 Meller J, Sahlmann CO, Ivančević V. Differentialindikation für verschiedene radioaktive Arzneimittel bei unterschiedlichen entzündlichen Erkrankungen. [Online] http://www.nuklearmedizin.de/leistungen/leitlinien/leitlinien.php?navId=53
• 70 Meller J, Siefker U, Becker W. Nuklearmedizinische Diagnostik erregerbedingter Skeletterkrankungen. Nuklearmediziner 2002; 25: 238-249
• 71 Morguet A, Munz DL, Ivančević V. et al. Clinical value of radioimaging using the murine monoclonal antigranulocyte antibody BW 250/183 in the diagnosis of prosthetic valve endocarditis. Dtsch Med Wochenschr 1995; 120: 861-866
• 72 Morguet A, Munz DL, Ivančević V. et al. Immunoscintigraphy using technetium-99m-labeled anti-NCA-95 antigranulocyte antibodies as an adjunct to echocardiography in subacute infective endocarditis. J Am Coll Cardiol 1994; 23: 1171-1178
• 73 Mota LG, Coelho LGV, Simal CarlosJR. et al. Leukocyte-technetium-99m uptake in Crohnʼs disease: does it schow subclinical disease?. World J Gastroenterol 2010; 16: 365-371
• 74 Munz DL, Morguet A, Sandrock D. et al. Radioimmunoimaging of subacute infective endocarditis using a technetium-99m monoclonal granulocyte-specific antibody. Eur J Nucl Med 1991; 18: 977-980
• 75 Neirinckx RD, Canning LR, Piper IM. et al. Technetium-99m d,l-HM-PAO: a new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion. J Nucl Med 1987; 28: 191-202
• 76 Pakos EE, Trikalinos TA, Fotopoulos AD. et al. Prosthesis Infection: Diagnosis after Total Joint Arthroplasty with Antigranulocyte Scintigraphy with 99mTc-labeled Monoclonal Antibodies-A Meta-Analysis. Radiology 2007; 242: 101-108
• 77 Palestro C, Swyer A, Kim C. et al. Infected knee prosthesis: diagnosis with In-111 leukocyte, Tc-99m sulfur colloid, and Tc-99m MDP imaging. Radiology 1991; 179: 645-648
• 78 Palestro CJ, Kim CK, Swyer AJ. et al. Total-hip arthroplasty: periprosthetic indium-111-labeled leukocyte activity and complementary technetium-99m-sulfur colloid imaging in suspected infection. J Nucl Med 1990; 31: 1950
• 79 Palestro CJ, Love C, Bhargava KK. Labeled leukocyte imaging: Current status and future directions. Q J Nucl Med Mol Imaging 2009; 53: 105-123
• 80 Palestro CJ, Love C, Tronco GG. et al. Combined Labeled Leukocyte and Technetium 99m Sulfur Colloid Bone Marrow Imaging for Diagnosing Musculoskeletal Infection. Radiographics 2006; 26: 859-870
• 81 Papos M, Nagy F, Naraii G. et al. Anti-granulocyte immunoscintigraphy and [99mTc]hexamethylpropyleneamine-oxime-labeled leukocyte scintigraphy in inflammatory bowel disease. Dig Dis Sci 1996; 41: 412-420
• 82 Parvizi J, Della Valle CJ. AAOS Clinical Practice Guideline: diagnosis and treatment of periprosthetic joint infections of the hip und knee. J Am Acad Orthop Surg 2010; 18: 771-772
• 83 Peters AM, Danpure HJ, Osman S. et al. Clinical experience with 99m Tc-hexamethylpropyleneamineoxime for labelling leucocytes and imaging inflammation. Lancet 1986; 2: 946-949
• 84 Petersdorf RB, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore) 1961; 40: 1-30
• 85 Petruzzi N, Shanthly N, Thakur M. Recent trends in soft tissue infection imaging. Semin Nucl Med 2009; 39: 115-123
• 86 Poirier JY, Garin E, Derrien C. et al. Diagnosis of osteomyelitis in the diabetic foot with a 99mTc-HMPAO leucocyte scintigraphy combined with a 99mTc-MDP bone scintigraphy. Diabetes Metab 2002; 28: 485-490
• 87 Prandini N, Lazzeri E, Rossi B. et al. Nuclear medicine imaging of bone infections. Nucl Med Commun 2006; 27: 633
• 88 Ramackers JM, Kotzki PO, Couret I. et al. The use of Technetium-99m hexamethylpropylene amine oxime labelled granulocytes with single-photon emission tomography imaging in the detection and follow-up of recurrence of infective endocarditis complicating transvenous endocardial pacemaker. Eur J Nucl Med 1995; 22: 1351-1354
• 89 Richter WS, Ivančević V, Meller J. et al. 99mTc-besilesomab (Scintimun^®) in peripheral osteomyelitis: comparison with 99mTc-labelled white blood cells. Eur J Nucl Med Mol Imaging 2011; 38: 899-910
• 90 Riise ØR, Kirkhus E, Handeland KS. et al. Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study. BMC Pediatrics 2008; 8: 45
• 91 Rubello D, Casara D, Maran A. et al. Role of antigranulocyte Fab´ fragment antibody scintigraphy (Leukoscan) in evaluating bone infection: acquisition protocol, interpretation criteria and clinical results. Nucl Med Commun 2004; 25: 39-47
• 92 Sans M, Fuster D, Llach J. et al. Optimization of technetium-99m-HMPAO leukocyte scintigraphy in evaluation of active inflammatory bowel disease. Dig Dis Sci 2000; 45: 1828-1835
• 93 Sapico FL, Montgomerie JZ. Pyogenic vertebral osteomyelitis: report of nine cases and review of the literature. Rev Infect Dis 1979; 1: 754-776
• 94 Scillaci O. Hybrid imaging systems in the diagnosis of osteomyelitis and prosthetic joint infection. Q J Nucl Med 2009; 53: 95-104
• 95 Scillaci O. Hybrid SPECT/CT: a new era for SPECT imaging?. Eur J Nucl Med mol Imaging 2005; 32: 521-524
• 96 Seeger JM. Management of patients with prosthetic vascular graft infection. Am Surg 2000; 66: 166-177
• 97 Segarra I, Roca M, Baliellas C. et al. Granulocyte-specific monoclonal antibody technetium-99m BW 250/183 and indium-111 oxine-labelled leucocyte scintigraphy in inflammatory bowel disease. Eur J Nucl Med 1991; 18: 715-719
• 98 Sfakianakis GN, Al-Sheilik W, Heal A. et al. Comparison of scintigraphy with In-111-leukocytes and Ga-67 in the diagnosis of occult sepsis. J Nucl Med 1982; 23: 618-626
• 99 Shahidi S, Eskil A, Lundof E. et al. Detection of Abdominal Aortic Graft Infection: Comparison of Magnetic Resonance Imaging and Indium-Labeled White Blood Cell Scanning. Ann Vasc Surg 2007; 21: 586-592
• 100 Simonsen L, Buhl A, Oersnes T. et al. White blood cell scintigraphy for differentiation of infection and aseptic loosening: A retrospective study of 76 painful hip prostheses. Acta Orthop 2007; 78: 640-647
• 101 Sousa R, Massada M, Pereira A. et al. Diagnostic accuracy of combined 99mTc-sulesosmab and 99mTc-nanocolloid bone marrow imaging in detecting prosthetic joint infection. Nucl Med Commun 2011; 32: 834-839
• 102 Spier BJ, Perlman SB, Reicheldorfer M. FDG PET in inflammatory bowel disease. Q J Nucl Med 2009; 53: 64-71
• 103 Termaat MF, Raijmakers PGHM, Scholten HJ. et al. The accuracy of diagnostic imaging of chronic osteomyelitis: a systematic review and meta-analysis. J Bone Joint Surg [Am] 2005; 87: 2464-2671
• 104 Tesche S, Meller B, Siefker U. et al. Seltene und spezielle Indikationen für eine nuklearmedizinische Entzündungsdiagnostik. Nuklearmediziner 2007; 30: 154-167
• 105 Thakur ML, Lavender JP, Arnot RN. et al. Indium-111-labeled autologous leukocytes in man. J Nucl Med 1977; 18: 1014-1021
• 106 Thakur ML, Segal AW, Louis L. et al. Indium-111-labelled cellular blood components: Mechanisms of labelling and intracellular location in human neutrophils. J Nucl Med 1977; 18: 1022-1026
• 107 Tillack C, Seiderer J, Brand S. et al. Correlation of magnetic resonance enteroclysis (MRE) and wireless capsule endoskopy (CE) in the diagnosis of small bowle lesions in Crohnʼs disease. Inflamm Bowel Dis 2008; 14: 1219-1228
• 108 Tudor GR, Finlay DB, Belton I. The value of In-111-labelled leukocyte imaging and ultrasonography in the investigation of pyrexia of unknown origin. Br J Radiol 1997; 70: 918-922
• 109 Vanninen E, Korppi M, Bergstrom KA. et al. Detection of focal inflammation with Tc99m-HMPAO labeled leukocytes in children. Clin Nucl Med 1993; 18: 570-572
• 110 Venderschueren S, Knockaert D, Adriaenssens T. et al. From prolonged febrile illness to fever of unknown origin. Arch Intern Med 2003; 163: 1033-1041
• 111 Waldvogel FA, Medoff G, Swartz MN. Osteomyelitis: A review of clinical features, therapeutic considerations and unusual aspects. N Engl Med J 1970; 282: 593-597
• 112 Xing D, Ma XL, Ma JX. et al. Use of Anti-Granulocyte Scintigraphy with 99mTc-Labeled Monoclonal Antibodies for the Diagnosis of Periprosthetic Infection in Patients after Total Joint Arthroplasty: A Diagnostic Meta-Analysis. PLOS ONE 2013; 8: e69857