Detection of gastrointestinal and abdominal infections by 99mTc-ciprofloxacin

Hepatogastroenterology. 2005 Mar-Apr;52(62):491-5.

Abstract

Background/aims: The aim of the study is detection and evaluation of the abdominal and gastrointestinal infective foci using 99mTc-ciprofloxacin (Laboratory for radioactive isotopes, Vinca).

Methodology: In total 21 patients with clinical suspicion on abdominal or gastrointestinal infection were investigated. In all the patients, planar liver/spleen scintigraphy was performed. Ciprofloxacin chloride (3.5 mg) was mixed with 555 MBq of 99mTc in 3 mL of physiological solution and incubated for 20 min. After slow i.v. injection in a cubital vein, dynamic acquisition (1 f/min) was performed during the first 60 min in the position of interest, followed by static acquisition (500,000 imp) anterior and posterior view, abdomen and pelvis after 1 h and 4 h in all patients. When necessary, additional scintigrams were acquired after 24 h. In all the patients with negative or equivocal findings of planar scintigraphy, emission computerized tomography (SPECT) was performed (60 positions, 6 degrees). Interpretation was made by three independent observers. Additional data were provided using clinical findings, ultrasonography, computed tomography and magnetic resonance imaging, laboratory analyses, and surgical or microbiological confirmation of infection.

Results: There were eleven true-positive findings, seven true negative, two were false negative while one was false positive due to intestinal obstruction. Sensitivity was 79%, specificity 91%, positive predictive value 92%, negative predictive value 77%, accuracy 84%.

Conclusions: According to our results, scintigraphy with radiolabeled ciprofloxacin is a useful method for detection and assessment of exact localization of abdominal and gastrointestinal infections.

MeSH terms

  • Abdomen / diagnostic imaging*
  • Bacterial Infections / diagnostic imaging*
  • Bacterial Infections / metabolism
  • Ciprofloxacin / analogs & derivatives*
  • Ciprofloxacin / pharmacokinetics
  • False Negative Reactions
  • False Positive Reactions
  • Gastrointestinal Diseases / diagnostic imaging*
  • Gastrointestinal Diseases / metabolism
  • Humans
  • Liver / diagnostic imaging
  • Liver / metabolism
  • Organotechnetium Compounds* / pharmacokinetics
  • Predictive Value of Tests
  • Radionuclide Imaging
  • Sensitivity and Specificity
  • Spleen / diagnostic imaging
  • Spleen / metabolism
  • Tissue Distribution

Substances

  • Organotechnetium Compounds
  • Technetium Tc 99m ciprofloxacin
  • Ciprofloxacin