Introduction In the present study, 99mTc-radiolabelled E-selectin binding peptide (99mTc-IMP-178) was investigated for its potential to image acutem pyogenic osteomyelitis in a new animal model. Intraindividual comparisons were performed using an irrelevant peptide (99mTc-IMP-100) to demonstrate specificity.
Methods An acute pyogenic osteomyelitis was induced by injecting 0.05 ml of 5% sodium morrhuate and 5×108 CFU of Staphylococcus aureus into the medullary cavity of the right tibia in 16 rats. Sixteen additional rats served as untreated controls. Whole-body imaging of pyogenic (n = 4) and untreated (n = 4) animals was performed continously during the first 8 h (12 MBq i.v. of 99mTc-IMP-178 and 99mTc-IMP-100 for control), and one further single image was acquired after 16 h p.i. Tissue biodistribution studies were performed in 12 rats with an acute pyogenic osteomyelitis and in 12 untreated rats 1, 4 and 24 h after injection. Data of the histological/radiological and haematological investigations were obtained in all animals.
Results Histopathologically, 15 of 16 treated rats (93%) developed an acute pyogenic osteomyelitis showing a major infiltration of the bone marrow by polymorphonuclear leukocytes as well as the formation of sequestra. Haematologically, the number of leukocytes increased by 100%, the lymphocytes by 11% and the granulocytes decreased by 39%. After i.v. injection, 99mTc-IMP-178 rapidly cleared from the body resulting in good scintigraphic target-to-background (T/B) ratios. The highest uptake of the tracer in the pyogenic bone was observed at 60 min p.i. (0.43±0.02% ID·g−1 for 99mTc-IMP-178 and 0.30±0.02% ID·g−1 for 99mTc-IMP-100), resulting in a higher osteomyelitis-to-healthy collateral ratio with T/B of 2.40±0.65 (99mTc-IMP-178) compared with 1.85±0.48 (99mTc-IMP-100). No adverse reactions were seen after injection of 99mTc-IMP-178.
Conclusions99mTc-IMP-178 allows imaging of an acute osteomyelitic lesions, presumably by interaction of 99mTc-IMP-178 with activated upregulated vascular endothelium.