Besilesomab for imaging inflammation and infection in peripheral bone in adults with suspected osteomyelitis

Adriana Blazeski¹, Kenneth M Kozloff^1,2, Peter JH Scott³

¹Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; ²Orthopedic Research Laboratories, Department of Orthopedic Surgery, ³Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA

Abstract: Early and accurate diagnosis of osteomyelitis, an inflammatory process of the bone caused by an infective microorganism, is essential for rapid management of the disease by antimicrobial and/or surgical intervention. Historically, diagnosis has been achieved by histological examination, but, more recently, sophisticated molecular imaging techniques (including computed tomography [CT], magnetic resonance imaging, positron emission tomography, single photon emission CT, scintigraphy) that are increasingly used to support diagnoses made from histological data have been reported. For example, scintigraphy has been used to visualize the inflammatory process in vivo using either radiolabeled leukocytes or radiolabeled antigranulocyte monoclonal antibodies (MAbs). Typically, radiolabeling is achieved using technetium-99m (radioactive half-life = 6.02 hours), and the most commonly used MAbs are the Fab fragment of the immunoglobulin (Ig)G antibody directed against the glycoprotein cross-reactive antigen-90 (sulesomab) and an IgG antibody against normal cross-reactive antigen-95 (BW 250/183, besilesomab [Scintimun^®]). The aim of the present review is to discuss use of this latter commercially available MAb, besilesomab, for imaging inflammation in adults with suspected osteomyelitis.

Keywords: Scintimun, ^99mTc scintigraphy, radiolabeled monoclonal antibodies, BW 250/183, bone infection