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........ published in NEWSLETTER # 53

by Dr. J. Martin_Comin, Hospital de Bellvitge, Barcelona (Spain)

A NATO Advanced Research Workshop was held in November 1992 in Barcelona to discuss the current status of blood elements labelling and analyze the most useful application in current clinical practice. The volume presented (NATO ASI SERIES A262) contains most of the conferences held at the meeting. The meeting was structured in different sections: In the first part the labelling method of blood cellular elements was discussed. In addition to 111In agents and 99mTc_HMPAO different monoclonal antibodies have appeared that promise, due to their storage possibilities and simplicity of labelling, a wider use of labelled blood cells in clinical practice. Special attention was given to the labelling (either with 99mTc or with 111In) of the unspecific polyclonal human immunoglobulin. Although its mechanism of action has not been totally established, its simplicity and ready availability makes it an attractive agent for imaging inflammatory foci. Another section discusses the first results of new peptides and molecular recognition units that, due to their lower antigenic potential, represent a very interesting alternative to monoclonal antibodies. Concerning platelet labelling, the most exciting presentation was their labelling with cyclotron product 68Ga and their potential use by both clinicians and nuclear physicians: Thrombus imaging. Finally, a method for labelling interleukin_2 for in vivo inflammation imaging was presented.

The most exciting section was probably the clinical applications. In the time elapsed (nearly two decades) since the beginning of scintigraphic uses of blood labelled cells, some of their applications seem to be clearly established. However, not enough specific labelled white blood cells and granulocytes are widely used (due to their high sensitivity) for the diagnosis and extension evaluation of bone infection, abscess detection and inflammatory bowel disease. Their accuracy in the detection of vascular prothesis infections has been highlighted in the August 1994 issue of the Journal of Nuclear Medicine. Unspecific human immunoglobulin seems to be a useful tool for reuhmathoid arthritis and bone inflammation studies and results of in vivo (animal and human) arteriosclerosis were presented. Labelled platelets are mainly used for kinetics studies in the field of haematology (idiopathic thromocitopenic purpura) and the search for an accurate thrombus imaging agent continues. Finally, applications of labelled lymphocytes in oncology are also presented.

In summary, both technical and clinical problems and challenges are discussed throughout the volume. It represents a useful state_of_the_art book for researchers in blood elements labelling and for clinicians looking for an updating of nuclear medicine diagnostic methods for their patients.
Reference books: A88, A152, A153, A262, E41

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