In-111 labeled leukocytes: a review of problems in image interpretation.

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Abstract
Leukocyte suspensions labeled with 111In oxine or tropoline were administered i.v. to 150 patients for the detection of suspected foci of bacterial infection by .gamma. camera imaging. The results were correlated with other imaging modalities, and clinical, laboratory and surgical findings after a minimum follow-up period of 6 mo. Of 29 foci of bacterial infection, 25 were demonstrated on the leukocyte-labeled images (sensitivity of detection = 86%). Three of the 4 missed lesions were chronic active osteomyelitis. The specificity of detection proved difficult to define, varying with different criteria for a false positive diagnosis. In every region of the body, a variety of lesions other than foci of bacterial infection produced positive uptake of the labeled leukocytes. An intense focal uptake was uncommon in lesions other than abscesses and hematoma. Imaging with labeled leukocytes apparently is valuable for demonstrating sites of infection in conjunction with other diagnostic methods. Detectable leukocytic infiltration, however, may occur in inflammatory lesions of any cause and in some noninflammatory states as well.