Imaging of infection and inflammation with 99mTc-fanolesomab

Charito Love, G. G. Tronco, C. J. Palestro

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

99mTc-fanolesomab, a murine M class antigranulocyte antibody, is injected directly into patients, avoiding in vitro leukocyte labeling. Normal distribution includes reticuloendothelial system, genitourinary tract, and blood pool. Small bowel activity appears within 4 h, colonic activity by 24 h. Accumulation in infection is via two mechanisms: binding to circulating neutrophils that migrate to the infection and binding to neutrophils and neutrophil debris containing CD-15 receptors already sequestered in the infection. 99mTc-fanolesomab is valuable in atypical appendicitis. Its sensitivity, specificity, and accuracy, in 200 patients were 91%, 86%, and 87%, respectively. This agent is comparable to 111In-labeled leukocytes for diagnosing osteomyelitis in the appendicular skeleton in general and in diabetic patients with pedal ulcers. Preliminary experience suggests 99mTc-fanolesomab might replace in vitro labeled leukocytes for other indications as well. Initial clinical investigations found the agent was safe. A transient decrease in circulating leukocytes within 20 min after injection occurred, but with no associated clinical complaints. Recovery averaged about 20 min. One study found no statistically significant HAMA titer elevation and no adverse reactions following injection. In another investigation 5 out of 30 subjects who received two separate antibody injections, exhibited HAMA induction with no serious or severe adverse events. Forty-nine adverse events, including 4 severe ones, were reported among 523 subjects in clinical trials. In 2004, 99mTc-falosomab was approved in the United States for use in patients with equivocal presentation of appendicitis. However, following post-marketing reports of serious adverse events, including two fatalities, the agent was withdrawn in late 2005, and its future is uncertain.

Original languageEnglish (US)
Pages (from-to)113-120
Number of pages8
JournalQuarterly Journal of Nuclear Medicine and Molecular Imaging
Volume50
Issue number2
StatePublished - Jun 2006
Externally publishedYes

Fingerprint

Leukocytes
Inflammation
Neutrophils
Appendicitis
Infection
Injections
Foot Ulcer
Mononuclear Phagocyte System
Immunoglobulin Isotypes
Normal Distribution
Osteomyelitis
Marketing
Skeleton
Clinical Trials
Sensitivity and Specificity
monoclonal antibody anti-SSEA-1
Antibodies
In Vitro Techniques

Keywords

  • Tc-fanolesomab
  • Infections
  • Inflammation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Imaging of infection and inflammation with 99mTc-fanolesomab. / Love, Charito; Tronco, G. G.; Palestro, C. J.

In: Quarterly Journal of Nuclear Medicine and Molecular Imaging, Vol. 50, No. 2, 06.2006, p. 113-120.

Research output: Contribution to journalArticle

@article{6e367fb9672549cf90a1e2abef7a419c,
title = "Imaging of infection and inflammation with 99mTc-fanolesomab",
abstract = "99mTc-fanolesomab, a murine M class antigranulocyte antibody, is injected directly into patients, avoiding in vitro leukocyte labeling. Normal distribution includes reticuloendothelial system, genitourinary tract, and blood pool. Small bowel activity appears within 4 h, colonic activity by 24 h. Accumulation in infection is via two mechanisms: binding to circulating neutrophils that migrate to the infection and binding to neutrophils and neutrophil debris containing CD-15 receptors already sequestered in the infection. 99mTc-fanolesomab is valuable in atypical appendicitis. Its sensitivity, specificity, and accuracy, in 200 patients were 91{\%}, 86{\%}, and 87{\%}, respectively. This agent is comparable to 111In-labeled leukocytes for diagnosing osteomyelitis in the appendicular skeleton in general and in diabetic patients with pedal ulcers. Preliminary experience suggests 99mTc-fanolesomab might replace in vitro labeled leukocytes for other indications as well. Initial clinical investigations found the agent was safe. A transient decrease in circulating leukocytes within 20 min after injection occurred, but with no associated clinical complaints. Recovery averaged about 20 min. One study found no statistically significant HAMA titer elevation and no adverse reactions following injection. In another investigation 5 out of 30 subjects who received two separate antibody injections, exhibited HAMA induction with no serious or severe adverse events. Forty-nine adverse events, including 4 severe ones, were reported among 523 subjects in clinical trials. In 2004, 99mTc-falosomab was approved in the United States for use in patients with equivocal presentation of appendicitis. However, following post-marketing reports of serious adverse events, including two fatalities, the agent was withdrawn in late 2005, and its future is uncertain.",
keywords = "Tc-fanolesomab, Infections, Inflammation",
author = "Charito Love and Tronco, {G. G.} and Palestro, {C. J.}",
year = "2006",
month = "6",
language = "English (US)",
volume = "50",
pages = "113--120",
journal = "Quarterly Journal of Nuclear Medicine and Molecular Imaging",
issn = "1824-4785",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "2",

}

TY - JOUR

T1 - Imaging of infection and inflammation with 99mTc-fanolesomab

AU - Love, Charito

AU - Tronco, G. G.

AU - Palestro, C. J.

PY - 2006/6

Y1 - 2006/6

N2 - 99mTc-fanolesomab, a murine M class antigranulocyte antibody, is injected directly into patients, avoiding in vitro leukocyte labeling. Normal distribution includes reticuloendothelial system, genitourinary tract, and blood pool. Small bowel activity appears within 4 h, colonic activity by 24 h. Accumulation in infection is via two mechanisms: binding to circulating neutrophils that migrate to the infection and binding to neutrophils and neutrophil debris containing CD-15 receptors already sequestered in the infection. 99mTc-fanolesomab is valuable in atypical appendicitis. Its sensitivity, specificity, and accuracy, in 200 patients were 91%, 86%, and 87%, respectively. This agent is comparable to 111In-labeled leukocytes for diagnosing osteomyelitis in the appendicular skeleton in general and in diabetic patients with pedal ulcers. Preliminary experience suggests 99mTc-fanolesomab might replace in vitro labeled leukocytes for other indications as well. Initial clinical investigations found the agent was safe. A transient decrease in circulating leukocytes within 20 min after injection occurred, but with no associated clinical complaints. Recovery averaged about 20 min. One study found no statistically significant HAMA titer elevation and no adverse reactions following injection. In another investigation 5 out of 30 subjects who received two separate antibody injections, exhibited HAMA induction with no serious or severe adverse events. Forty-nine adverse events, including 4 severe ones, were reported among 523 subjects in clinical trials. In 2004, 99mTc-falosomab was approved in the United States for use in patients with equivocal presentation of appendicitis. However, following post-marketing reports of serious adverse events, including two fatalities, the agent was withdrawn in late 2005, and its future is uncertain.

AB - 99mTc-fanolesomab, a murine M class antigranulocyte antibody, is injected directly into patients, avoiding in vitro leukocyte labeling. Normal distribution includes reticuloendothelial system, genitourinary tract, and blood pool. Small bowel activity appears within 4 h, colonic activity by 24 h. Accumulation in infection is via two mechanisms: binding to circulating neutrophils that migrate to the infection and binding to neutrophils and neutrophil debris containing CD-15 receptors already sequestered in the infection. 99mTc-fanolesomab is valuable in atypical appendicitis. Its sensitivity, specificity, and accuracy, in 200 patients were 91%, 86%, and 87%, respectively. This agent is comparable to 111In-labeled leukocytes for diagnosing osteomyelitis in the appendicular skeleton in general and in diabetic patients with pedal ulcers. Preliminary experience suggests 99mTc-fanolesomab might replace in vitro labeled leukocytes for other indications as well. Initial clinical investigations found the agent was safe. A transient decrease in circulating leukocytes within 20 min after injection occurred, but with no associated clinical complaints. Recovery averaged about 20 min. One study found no statistically significant HAMA titer elevation and no adverse reactions following injection. In another investigation 5 out of 30 subjects who received two separate antibody injections, exhibited HAMA induction with no serious or severe adverse events. Forty-nine adverse events, including 4 severe ones, were reported among 523 subjects in clinical trials. In 2004, 99mTc-falosomab was approved in the United States for use in patients with equivocal presentation of appendicitis. However, following post-marketing reports of serious adverse events, including two fatalities, the agent was withdrawn in late 2005, and its future is uncertain.

KW - Tc-fanolesomab

KW - Infections

KW - Inflammation

UR - http://www.scopus.com/inward/record.url?scp=33745892357&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745892357&partnerID=8YFLogxK

M3 - Article

VL - 50

SP - 113

EP - 120

JO - Quarterly Journal of Nuclear Medicine and Molecular Imaging

JF - Quarterly Journal of Nuclear Medicine and Molecular Imaging

SN - 1824-4785

IS - 2

ER -