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Nuclear Medicine and Infection Detection: The Relative Effectiveness of Imaging with ¹¹¹In-Oxine-, ^99mTc-HMPAO-, and ^99mTc-Stannous Fluoride Colloid-Labeled Leukocytes and with ⁶⁷Ga-Citrate^*

School of Medical Radiation Sciences, University of Sydney, Sydney, New South Wales, Australia

ABSTRACT

With a current annual mortality rate of around 35% worldwide, infection remains a significant concern, and the diagnosis and localization of infectious foci is an important health issue. As an established infection-imaging modality, nuclear medicine plays a vital health-care role in the diagnosis and subsequent effective treatment of this condition. Despite the development of several newer radiopharmaceuticals, ⁶⁷Ga and leukocyte imaging procedures have maintained their established place for infection. Several techniques in nuclear medicine significantly aid infection diagnosis, including imaging with ¹¹¹In-oxine-, ^99mTc-hexamethylpropyleneamine oxime-, and ^99mTc-stannous fluoride colloid-labeled leukocytes and with ⁶⁷Ga-citrate. Each radiopharmaceutical has specific advantages and disadvantages that make it suitable to diagnose different infectious processes (e.g., soft-tissue sepsis, inflammatory bowel disease, osteomyelitis, occult fever, fever of unknown origin, and infections commonly found in immunocompromised patients). After finishing this article, the reader should be able to identify the properties of an ideal radiopharmaceutical for infection imaging, list a range of available infection-imaging radiopharmaceuticals, compare the relative results of a range of radiopharmaceuticals used internationally to detect infection in the body, understand several common infectious processes that can be diagnosed using nuclear medicine techniques, and select an appropriate radiopharmaceutical to image a range of infectious processes.

Key Words: infection; ⁶⁷Ga; ¹¹¹In; HMPAO; colloid

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