Clinical indications, image acquisition and data interpretation for white blood cells and anti-granulocyte monoclonal antibody scintigraphy: an EANM procedural guideline

TLDR

Radiolabelled autologous white‑blood‑cell scintigraphy is being standardized worldwide to ensure high quality, specificity, and reproducibility, and many European countries use radiolabelled anti‑granulocyte antibodies instead, achieving high diagnostic accuracy. The guideline aims to support and promote good clinical practice by providing standardized image acquisition, display, analysis, interpretation protocols, and clinical application guidance for radiolabelled WBC and anti‑granulocyte antibody scintigraphy. The EANM Inflammation & Infection Committee developed and validated these guidelines, building on the standardized WBC labelling procedure and published evidence, to establish protocols for image acquisition, display, analysis, and interpretation. The guidelines recommend universal adoption by nuclear medicine centers to achieve highly reproducible standardized practice.

Abstract

Radiolabelled autologous white blood cells (WBC) scintigraphy is being standardized all over the world to ensure high quality, specificity and reproducibility. Similarly, in many European countries radiolabelled anti-granulocyte antibodies (anti-G-mAb) are used instead of WBC with high diagnostic accuracy. The EANM Inflammation & Infection Committee is deeply involved in this process of standardization as a primary goal of the group. The main aim of this guideline is to support and promote good clinical practice despite the complex environment of a national health care system with its ethical, economic and legal aspects that must also be taken into consideration. After the standardization of the WBC labelling procedure (already published), a group of experts from the EANM Infection & Inflammation Committee developed and validated these guidelines based on published evidences. Here we describe image acquisition protocols, image display procedures and image analyses as well as image interpretation criteria for the use of radiolabelled WBC and monoclonal antigranulocyte antibodies. Clinical application for WBC and anti-G-mAb scintigraphy is also described. These guidelines should be applied by all nuclear medicine centers in favor of a highly reproducible standardized practice.