THE ROLE OF NUCLEAR-MEDICINE IN DIAGNOSIS OF CATHETER-RELATED INFECTIONS

Infections represent a complication after transient or permanent impla ntation of medical devices (e. g. catheters or pacemaker systems), lea ding in many cases to therapeutic consequences such as the removal of the implanted system. Diagnosis of foreign body infections is difficul t and mainly based on clinical findings rather than laboratory methods or modern morphological imaging tools. Two-dimensional echocardiograp hy by transthoracic and transesophageal approach may be helpful in the detection of vegetations, but is not very sensitive for infections. M ost methods in nuclear medicine, however, are based on function and no t on form: some methods for the detection of an infection are unspecif ic like the use of labelled nanocolloids Or Ga-67-citrate, or they nee d rime-consuming and susceptible techniques for the labelling of autol ogous leukocytes. Monoclonal antibodies against epitopes on granulocyt es, 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.