• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.84-91
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• 1995

Many clinical and laboratory tests have been employed to evaluate disease activity in rheumatioid arthritis. $^{99m}Tc$-labelled polyclonal IgG(HIG) has been demonstrated to accumulate in focal sites of infection or inflammation in both animals and human subjects. The purpose of this study was to distinguish arthritis with active inflammation from those without active inflammation and to correlate relative intensities of $^{99m}Tc$-labelled HIG uptake of the rheumatoid arthritis with clinical and MR indices of the joint inflammation. This study included twelve patients with active rheumatoid arthritis, two with ankylosing spondylitis and one with degenerative osteoarthritis without active inflammation. A Whole-body and spot images were obtained 4 hours after intravenous injection of 20mCi of $^{99m}Tc$-labelled HIG. Scintigrams were assessed visually by 3 experienced radiologists, and graded as normal or mildly and markedly increased uptake within the joints, and the degree of uptake was compared with clinical and radiologic severity of synovial inflammation. MRI studies were done on the involved joints consisted of wrist(n = 11), knee(n = 2) and hip joint(n= 2). Active synovitis was defined when marked elevation of ESR and gadolinium enhancement of synovium on MRI were demonstrated. Markedly increased radiotracer uptake was seen in 10 of 11 rheumatoid arthritic patients with active synovitis whereas normal or mildly increased uptakes were noted in others, including rheumatoid arthritic patient(n=1) and non-rheumatoid patients(n = 3) without active synovitis. This study showed that the localization of involved joints in rheumatoid arthritis could be detected with $^{99m}Tc$-labelled HIG and that the degree of uptake correlated well with the degree and activity of inflammation. In conclusion, $^{99m}Tc$-labelled HIG scan is a useful method in the evaluation of active inflammation in rheumatoid arthritis.

• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.92-97
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• 1995

감염병소와 진단을 위해 여러 방사성성핵종 표지 사람비특이항체들이 임상이용되었으나, $^{123}I,\;^{99m}Tc,\;^{111}In$등 표지 핵종과 표지방법에 따른 체내동태의 차이에 대한 자료가 필요하며, 감염병소의 진단에 표준적으로 이용되어지던 $^{111}In$-oxine표지백혈구와 비교평가도 요구된다. 저자들은 $10^9$개의 포도상구균을 좌측 대퇴부에 주사하여 농양을 유발한 백서에서 $^{123}In$ 표지, iminothiolane을 이용한 $^{99m}Tc$ 표지, DTPA이용 $^{111}In$ 표지 사람비특이항체와 $^{111}In$-oxine 표지 백혈구의 체내동태 및 농양섭취율을 비교하였다. $^{123}In$-IgG는 갑상선 및 위의 방사능이 높아 체내 탈요드반응이 빠름이 시사되었으며, $^{99m}Tc$-iminothiolane IgG는 신장방사능이 높아 신장으로 IgG 또는 대사물이 배설됨을 알 수 있었다. $^{111}In$-oxine표지 백혈구는 간 및 비장의 방사능이 높았고, 혈액방사능 제거율이 가장 빨랐다. 주사 24시간 후의 농양섭취율은 $^{111}In$-DTPA IgG가 가장 높았고, 농양 대 혈액 방사능비는 $^{111}In$-oxine표지 백혈구가 가장 높았으며, $^{111}In$-DTPA IgG와 $^{99m}Tc$-iminothiolane IgG가 다음으로 비슷하였다. $^{111}In$-oxine표지 백혈구보다는 방사성핵종표지 IgG가 간편하게 이용될 수 있으며, $^{111}In$ 이 $^{99m}Tc$나 $^{123}In$보다 지연영상의 촬영에 유리함을 알 수 있었다.