Infection, Inflammation: Guidelines
The aim of this guideline is to provide general information about performing 18F-FDG PET or PET/CT imaging in the field of inflammatory and infectious disorders. Since the use of 18F-FDG imaging in inflammation and infection is rapidly evolving these guidelines cannot be seen as definitive. Therefore, the indications mentioned within this guideline should be regarded as current advice and areas for clinical research rather than as fully approved clinical indications. This guideline complements the EANM and SNMMI guidelines for the use of 18F-FDG PET for tumor imaging and, to avoid duplication, will not reproduce any statements that overlap. These include information concerning PET or PET/CT camera performance and quality control, general acquisition parameters, radiopharmaceutical acceptance, and general basic and clinical aspects of 18F-FDG imaging that may apply to both tumor and infection/ inflammation imaging. The document has been endorsed by the SNMMI Board.
A protocol is described for labelling autologous white blood cells with 111In-oxine based on previously published consensus papers and guidelines. This protocol includes quality control and safety procedures and is in accordance with current European Union regulations and International Atomic Energy Agency recommendations.
A protocol is described for labelling autologous white blood cells with 99mTc-HMPAO based on previously published consensus papers and guidelines. This protocol includes quality control and safety procedures and is in accordance with current European Union regulations and International Atomic Energy Agency recommendations.
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide interpreting physicians in performing scintigraphy for inflammation and infection. Properly performed imaging with radiopharmaceuticals that localize in inflamed or infected tissue is an effective means of detecting and evaluating many overt or occult infections. Correlation with clinical findings and other imaging modalities is imperative for maximum diagnostic yield. For this guideline, discussion is limited solely to agents that are not organ specific. The reader is referred to the guidelines covering scintigraphy of specific organs (e.g., the ACR Practice Guideline for the Performance of Adult and Pediatric Skeletal Scintigraphy for osteomyelitis and the ACR–SPR Practice Guideline for the Performance of Adult and Pediatric Hepatobiliary Scintigraphy for acute cholecystitis) for a discussion of those organs.
67Ga scintigraphy may include regional, whole-body, planar, and SPECT scintigrams, or any combination performed after intravenous injection of 67Ga-citrate.
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of 99mTc-Exametazime (HMPAO)-Labeled Leukocyte Scintigraphy . 99mTc-leukocyte scintigraphy consists of regional, whole-body, planar, and SPECT scintigrams obtained after intravenous injection of 99mTc-labeled leukocytes for suspected infection/inflammation.
111In-leukocyte scintigraphy is a diagnostic imaging test that displays the distribution of radiolabeled leukocytes in the body. Regional, whole-body, planar, and/or SPECT scintigrams of specific anatomic regions are obtained for suspected infection/inflammation.