View source for Chemistry:Indium-111 WBC scan

{{Short description|Nuclear medicine procedure}}
{{Infobox diagnostic
 | Name        = Indium-111 WBC scan
 | Image       =
 | Caption     =
 | ICD10       = C?1?DZZ (planar)<BR>C?2?DZZ (tomographic)
 | ICD9        = {{ICD9proc|92.18}}
 | MeshID      =
 | OPS301      = {{OPS301|3-70c}}
 | LOINC       = {{LOINC|25032-4}}, {{LOINC|41772-5}}, {{LOINC|41836-8}}, {{LOINC|42711-2}}
 | Synonyms  = '''Indium leukocyte imaging''', '''Indium-111 scan''', '''Indium scan'''
}}
The '''indium white blood cell scan''' is a [[Medicine:Nuclear medicine|nuclear medicine]] procedure in which white blood cells (mostly [[Biology:Neutrophil|neutrophil]]s) are removed from the patient, tagged with the radioisotope [[Chemistry:Indium|Indium]]-111, and then injected intravenously into the patient. The tagged leukocytes subsequently localize to areas of relatively new infection. The study is particularly helpful in differentiating conditions such as [[Medicine:Osteomyelitis|osteomyelitis]] from decubitus ulcers for assessment of route and duration of [[Chemistry:Antibiotic|antibiotic]] therapy.<ref>{{cite web |url=http://www.theabr.org |title=American Board Of Radiology |author=American Board of Radiology |publisher=American Board of Radiology |access-date=July 16, 2009}}</ref><ref>{{cite journal |last1=Van Nostrand |first1=D. |last2=Abreu |first2=S. H. |last3=Callaghan |first3=J. J. |last4=Atkins |first4=F. B. |last5=Stoops |first5=H. C. |last6=Savory |first6=C. G. |date=May 1988 |title=In-111-labeled white blood cell uptake in noninfected closed fracture in humans: prospective study. |journal=Radiology |volume=167 |issue=2 |pages=495–498 |publisher=Radiological Society of North America, Inc. |doi=10.1148/radiology.167.2.3357961 |url=http://radiology.rsna.org/content/167/2/495.short |archive-url=https://archive.today/20120714140238/http://radiology.rsna.org/content/167/2/495.short |url-status=dead |archive-date=2012-07-14 |access-date=July 20, 2011 |pmid=3357961 }}</ref>

In imaging of infections, the [[Chemistry:Gallium scan|gallium scan]] has a sensitivity advantage over the indium white blood cell scan in imaging [[Medicine:Osteomyelitis|osteomyelitis]] (bone infection<ref>{{cite journal |vauthors=Verberne SJ, Raijmakers PG, Temmerman OP | year = 2016 | title = The Accuracy of Imaging Techniques in the Assessment of Periprosthetic Hip Infection: A Systematic Review and Meta-Analysis | journal = The Journal of Bone and Joint Surgery. American Volume | volume = 98 | issue = 19| pages = 1638–1645 | pmid = 27707850 | doi=10.2106/JBJS.15.00898}}</ref>) of the spine, lung infections and inflammation, and in detecting chronic infections. In part, this is because gallium binds to neutrophil membranes, even after neutrophil death, whereas localization of neutrophils labeled with indium requires them to be in relatively good functional order. However, indium leukocyte imaging is better at localizing acute (i.e., new) infections, where live neutrophils are still rapidly and actively localizing to the infection, for imaging for osteomyelitis that does not involve the spine, and for locating abdominal and pelvic infections.

Both the gallium scan and indium-111 white blood cell imaging may be used to image [[Medicine:Fever of unknown origin|fever of unknown origin]] (elevated temperature without an explanation). However, the indium leukocyte scan will localize only to the approximately 25% of such cases which are caused by acute infections, while gallium is more broadly sensitive, localizing to other sources of fever, such as chronic infections and tumors. Gallium may be a better choice for spleen study because gallium does not normally accumulate in the spleen.

==See also==
* [[Medicine:Radiology|Radiology]]
* [[Medicine:Nuclear medicine|Nuclear medicine]]
* [[Chemistry:Gallium scan|Gallium scan]]
* [[Physics:Indium-111|Indium-111]]

==References==
{{reflist}}

{{Medical imaging}}

[[Category:Radiation therapy]]
[[Category:Indium]]

{{Sourceattribution|Indium-111 WBC scan}}