The Role of Nuclear Medicine in Diagnosis of Catheter-related Infections

Abstract

Infections represent a complication after transient or permanent implantation of medical devices (e.g. catheters or pacemaker systems), leading in many cases to therapeutic consequences such as the removal of the implanted system. Diagnosis of foreign body infections is difficult and mainly based on clinical findings rather than laboratory methods or modern morphological imaging tools. Two-dimensional echocardiography by transthoracic and transesophageal approach may be helpful in the detection of vegetations, but is not very sensitive for infections. Most methods in nuclear medicine, however, are based on function and not on form: some methods for the detection of an infection are unspecific like the use of labelled nanocolloids or Ga-67-citrate, or they need time-consuming and susceptible techniques for the labelling of autologous leukocytes. Monoclonal antibodies against epitopes on granulocytes, however, offer a fast and reliable in-vivo labelling technique. It has been demonstrated in a group of four patients that scintigraphic detection of pacemaker infections by immunoscintigraphy may represent a valuable diagnostic tool.