The scintigraphy with radiolabelled autologous leukocytes (WBCs) is considered the gold-standard technique for imaging infections. Leukokit® is a commercially available, disposable, sterile kit for labelling WBCs ex vivo. In this kit, WBCs isolation from red blood cells (RBCs) was performed using poly(O-2-hydroxyethyl)starch (HES) as the RBCs sedimentation agent. Due to its poor availability, HES has been recently replaced by Gelofusine as the RBC sedimentation agent. The aim of this study was to compare the labelling efficiency and the diagnostic accuracy of WBCs labelled with Leukokit® with HES vs Leukokit® with Gelofusine. WBCs were isolated using HES or Gelofusine for 45 minutes and then purified from platelets (PLTs) and labelled with 1.1 ± 0.3 GBq of freshly prepared 99mTc-HMPAO. The following parameters were evaluated: the number and type of recovered WBCs, RBCs contamination, PLTs contamination, vitality of neutrophils, and chemotactic properties of neutrophils. Clinical comparison was performed between 80 patients (33 males; age 67.5 ± 14.2) injected with 99mTc-HMPAO-WBCs, using HES as the sedimentation agent, and 92 patients (38 males; age 68.2 ± 12.8) injected with 99mTc-HMPAO-WBCs using Gelofusine as the sedimentation agent. Patients were affected by prosthetic joint infections, peripheral bone osteomyelitis, or vascular graft infection. We compared radiolabelling efficiency (LE), final recovery yield (RY), and diagnostic outcome based on microbiology or 2-year follow-up. Results showed that HES provides the lowest RBCs and PLTs contamination, but Gelofusine provides the highest WBC recovery. Both agents did not influence the chemotactic properties of WBCs, and no differences were found in terms of LE and RY. Sensitivity, specificity, and accuracy were also not significantly different for WBCs labelled with both agents (diagnostic accuracy 90.9%, CI = 74.9-96.1 vs 98.3%, CI = 90.8-100, for HES and Gelofusine, respectively). In conclusion, Gelofusine can be considered a suitable alternative of HES for WBCs separation and labelling.

中文翻译：

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使用带有 Gelofusine 的 Leukokit® 与带有 HES 作为沉降剂的 Leukokit® 进行 99mTc-HMPAO 标记的人类白细胞的标记和临床性能。

使用放射性标记的自体白细胞 (WBC) 进行的闪烁扫描被认为是感染成像的金标准技术。Leukkit® 是一种市售的一次性无菌试剂盒，用于离体标记白细胞。在该试剂盒中，使用聚（O-2-羟乙基）淀粉（HES）作为红细胞沉降剂从红细胞（RBC）中分离白细胞。由于其可用性较差，HES 最近已被 Gelofusine 取代作为红细胞沉降剂。本研究的目的是比较 Leukokit® with HES 与 Leukokit® with Gelofusine 标记的白细胞的标记效率和诊断准确性。使用 HES 或 Gelofusine 分离 WBC 45 分钟，然后从血小板 (PLT) 中纯化，并用 1.1 ± 0.3 GBq 的新鲜制备的 99mTc-HMPAO 进行标记。评估以下参数：回收的白细胞数量和类型、红细胞污染、PLT污染、中性粒细胞活力和中性粒细胞趋化特性。使用 HES 作为沉淀剂，对 80 名患者（33 名男性；年龄 67.5 ± 14.2）注射 99mTc-HMPAO-WBCs 和 92 名患者（38 名男性；年龄 68.2 ± 12.8）注射 99mTc-HMPAO-WBCs 进行临床比较使用格洛夫辛作为沉淀剂。患者受到假体关节感染、周围骨骨髓炎或血管移植物感染的影响。我们比较了放射性标记效率 (LE)、最终回收率 (RY) 以及基于微生物学或 2 年随访的诊断结果。结果显示，HES 提供的红细胞和 PLT 污染最低，但格洛夫辛提供最高的白细胞回收率。两种药物均不影响 WBC 的趋化特性，并且 LE 和 RY 方面未发现差异。两种药物标记的白细胞的敏感性、特异性和准确性也没有显着差异（HES 和格洛夫辛的诊断准确性分别为 90.9%，CI = 74.9-96.1 vs 98.3%，CI = 90.8-100）。总之，Gelofusine 可以被认为是 HES 的合适替代品，用于白细胞分离和标记。