Poster prizewinners include controversial imaging agent

January 17, 2006

On the same day that New York researchers received the top honor at the RSNA meeting for their poster detailing the benefits of an infection imaging agent, the drug's maker issued a warning about two deaths and additional serious adverse events attributed to its use. The admonition was released by Tyco Mallinckrodt Healthcare, which markets NeutroSpec (technetium-99m fanolesomab), a monoclonal antibody-labeled radiopharmaceutical agent approved in the U.S. for the diagnosis of equivocal appendicitis.

On the same day that New York researchers received the top honor at the RSNA meeting for their poster detailing the benefits of an infection imaging agent, the drug's maker issued a warning about two deaths and additional serious adverse events attributed to its use. The admonition was released by Tyco Mallinckrodt Healthcare, which markets NeutroSpec (technetium-99m fanolesomab), a monoclonal antibody-labeled radiopharmaceutical agent approved in the U.S. for the diagnosis of equivocal appendicitis.

The deaths and severe reactions happened within 30 minutes of injection. Onset generally required resuscitation with fluids, vasopressors, and oxygen, according to the announcement. A majority of the incidents involved patients with underlying cardiopulmonary disease and off-label applications. The company did not disclose the number of nonfatal adverse events.

"The news was a bit disappointing to us," said Dr. Christopher Palestro, senior author of the award-winning poster. "In light of the letter issued by Mallinckrodt and because there are other available agents, we've decided to suspend use of this agent."

Recent research with the agent has focused on its off-label uses. Led by Dr. Josephine N. Rini, the winning investigators from the division of nuclear medicine at Long Island Jewish Medical Center had written that NeutroSpec was comparable to in vitro indium-111-labeled leukocytes for diagnosing diabetic pedal osteomyelitis and predicted that the agent would be useful for diagnosing other infections. Palestro said that his team experienced no adverse reactions from the use of the agent.

Another poster prizewinner chronicled a different type of controversy: the increasing number of injuries associated with all-terrain vehicles. ATVs can reach speeds of more than 80 miles per hour, but few use restrictions exist, according to Dr. Brian J. Montague and colleagues at the University of California, San Diego.

Researchers documented 125 trauma admissions to UCSD Medical Center from ATVs, nearly 90% of them male patients. Only 53 drivers wore helmets, and 22 serious injuries resulted. Hospital stays averaged 5.1 days, with a mean charge per stay of $55,890. Common injuries included lumbar spine fracture, thoracic spine fracture, and maxillofacial fracture.

An RSNA poster assessing MRI's utility in myocardial perfusion garnered first prize for cardiac imaging. Scott A. Reid, Ph.D., and colleagues from the University of Leeds in the U.K. discussed modified look-locker inversion (MOLLI) recovery.

James Brice and C.P. Kaiser contributed to this story.