Optimization of technetium-99m-HMPAO leukocyte scintigraphy in evaluation of active inflammatory bowel disease

• Published in: Digestive diseases and sciences Vol. 45; no. 9; pp. 1828 - 1835
• Main Authors: SANS, Miquel, FUSTER, David, LLACH, Josep, LOMENA, Francisco, BORDAS, Josep Maria, HERRANZ, N, PIQUE, Josep Maria, PANES, Julian
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.09.2000; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Colitis, Ulcerative - diagnostic imaging; Crohn Disease - diagnostic imaging; Digestion. Liver. Biliary tract. Spleen. Pancreas; Female; Humans; Inflammatory bowel disease; Inflammatory Bowel Diseases - diagnostic imaging; Investigative techniques, diagnostic techniques (general aspects); Leukocytes; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Prospective Studies; Radionuclide Imaging; Radionuclide investigations; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Exametazime; Radionuclide study; Human; Leukocyte; Technetium; Scintigraphy; Optimization; Inflammatory disease; Crohn disease; Digestive diseases; Medical imagery; Intestinal disease; Diagnosis; Technique; Ulcerative colitis
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1023/A:1005513723968

Although [99mTc]HMPAO-labeled leukocyte scintigraphy is widely used in the assessment of IBD, the time point chosen for imaging is still controversial. The aim of the present study was to determine the optimal scanning sequence to assess IBD extension and activity. Sixty-two consecutive patients with active and 18 with inactive IBD were prospectively studied. Clinical evaluation, colonoscopy, radiology, and scintigraphy were performed within three days, without changes in the patient's treatment. Compared to early scan (45 min), late scan (3 hr) had a higher sensitivity (85% vs 100%) and accuracy (85% vs 95%) in identifying patients with active IBD and in defining IBD extension. Combinations of values from both scans did not improve accuracy of scintigraphy, which is lower in Crohn's disease than in ulcerative colitis and also in patients receiving steroid treatment. In conclusion, a single late scintigraphy scan provides the best means to identify patients with active IBD and to assess disease extension.