Seltene und spezielle Indikationen für eine nuklearmedizinische Entzündungsdiagnostik

This article gives an evidence-based overview about several special indications for scintigraphy in imaging infection and inflammation. In diagnosing and evaluating the extent of inflammatory bowel disease, the scintigraphy with 99m Tc-HMPAO labelled leucocytes remains the standard evaluation in Nuclear Medicine. Appendicitis can be proven or excluded with a high grade of certainty both by 99m Tc-labelled monoclonal antigranulocytic antibodies and FAb′-fragments and by in-vitro labelled leucocytes. In endocarditis a late SPECT (20-24 h p. i.) with a 99m Tc-labeled anti-CD66 monoclonal antibody is a useful adjunct to echocardiographic techniques. In infected vascular prostheses, 99m Tc-HMPAO-labelled autologous leucocytes remain the standard of Nuclear Medicine although [ 18 F]FDG-PET or [ 18 F]FDG-PET / CT may exhibit a higher diagnostic accuracy.