Nuclear Medicine imaging of vertebral infections: role of radiolabelled biotin

This thesis describes the clinical use of a new infection tracer, namely 111In-Biotin, for the diagnosis of vertebral infection.
The low specificity of labelled antibiotics used for the diagnosis of infection in animal models is discussed. Because of their mechanism of action none of these agents is unable to bound exclusively to bacteria (Chapter 2).
Chapter 4 describes the first study of the avidin/111Indium-biotin approach in patients with bone infections. This study was performed in patients with various orthopaedic pathologies (intermediate suspected osteomyelitis of the trunk, infection/inflammation of prosthetic joint replacements and suspected osteomyelitis of appendicular bones). A comparison between Avidin/111In-biotin scintigraphy and 99mTc-HMPAO-labelled leukocyte scintigraphy is presented. The diagnostic performance of avidin/111Inbiotin scintigraphy in patients with prosthetic joint replacements or osteomyelitis of appendicular bones was similar to that of 99mTc-HMPAO leukocyte scintigraphy, while the avidin/111In-biotin approach clearly performed better than 99mTc-HMPAO leukocyte scintigraphy in patients with suspected vertebral osteomyelitis.
In Chapter 5 it is decribed the evaluation of the diagnostic performance of the two-step streptavidin/111In-biotin imaging in patients with suspected vertebral osteomyelitis. Scintigraphic results are compared with radiological imaging (MRI and CT). Streptavidin/111In-biotin scintigraphy is highly sensitive and specific for early detection of vertebral osteomyelitis and its accuracy is clearly higher than for either MRI or CT.
This study evaluates the potential of 111In-Biotin scintigraphy to diagnose vertebral infections in patients with suspected hematogenous and postsurgical infections. The results showed that 111In-Biotin scintigraphy presents high diagnostic accuracy.
Chapter 7 describes and estabilishes the add value of SPECT/CT acquisition of 111In-biotin scintigraphy for diagnosis of vertebral infection, moreover in differentiation between bone and soft paravertebral tissues involvement respect on planar and SPECT images. 111In-Biotin SPECT/CT is able to differentiate between bone and/or soft tissues involvement of infection and it is a valid tool before choose a correct therapy in clinical setting.

	Titel en inhoudsopgave
	Hoofdstuk 1
	Hoofdstuk 2
	Hoofdstuk 3
	Hoofdstuk 4
	Hoofdstuk 5
	Hoofdstuk 6
	Hoofdstuk 7
	Hoofdstuk 8
	Engelse samenvatting
	Conclusies en toekomstperspectieven
	Curriculum vitae
	Dankwoord
	Volledige dissertatie

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