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PURPOSE: Evaluation and comparison between pentavalent 99mTc dimercaptosuccinic acid (99mTc(V)-DMSA) and 99mTc-hexamethylpropylene amine oxime white blood cell (99mTc-HMPAO WBC) scintigraphy in the detection and assessment of disease activity in patients with active inflammatory bowel disease (IBD). MATERIALS AND METHODS: 99mTc(V)-DMSA scintigraphy was performed in 23 patients with active IBD and true positive 99mTc-HMPAO WBC scintigraphy. Images were considered positive when an area of increased uptake was observed. To assess severity of IBD, semi-quantitative analysis was included with reference to the uptake in the iliac crest. Comparison with endoscopic, radiological and clinical data was performed. RESULTS: The diagnostic accuracy of 99mTc-HMPAO WBC and 99mTc(V)-DMSA was 91% and 84%, respectively. A significant correlation between the findings of both radioisotopic methods and scintigraphy score was demonstrated. Endoscopic findings were significantly correlated with scintigraphic results. Kappa statistics showed a moderate to good agreement between the two scintigraphic methods. Two patients (8.8%) had negative findings with 99mTc(V)-DMSA scintigraphy (false negative results). CONCLUSION: 99mTc(V)-DMSA compared to 99mTc-HMPAO WBC could provide a simple, non-invasive alternative method for the assessment of disease activity, although it is slightly inferior to 99mTc-HMPAO WBC scintigraphy especially in the evaluation of disease localization in IBD patients.

Original publication

DOI

10.1097/mnm.0b013e3282f1bc37

Type

Journal article

Journal

Nuclear medicine communications

Publication Date

01/2008

Volume

29

Pages

27 - 32

Addresses

Department of Nuclear Medicine, University Hospital of Heraklion, Medical School, University of Crete, Crete, Greece.

Keywords

Leukocytes, Humans, Inflammatory Bowel Diseases, Technetium Tc 99m Exametazime, Technetium Tc 99m Dimercaptosuccinic Acid, Radiopharmaceuticals, Sensitivity and Specificity, Reproducibility of Results, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male