Technetium-99m hexamethyl propylene amine oxime-labeled leukocyte scintigraphy at three different times in active ulcerative colitis: comparison with colonoscopy and clinico-biochemical parameters in the assessment of disease extension and severity

• Published in: Annals of nuclear medicine 2008-06, Vol.22 (5), p.371-377
• Main Authors: Aydın, Funda, Dinçer, Dinç, Güngör, Fırat, Boz, Adil, Akça, Serdar, Yıldız, Akın, Tosun, Özgür, Karayalçın, Binnur
• Format: Article
• Language: English
• Subjects: Adult; Colitis, Ulcerative - diagnostic imaging; Disease Progression; Drug Administration Schedule; Female; Humans; Imaging; Leukocytes - diagnostic imaging; Male; Medicine; Medicine & Public Health; Nuclear Medicine; Original Article; Radiology; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Technetium Tc 99m Exametazime
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-008-0131-6

Objective In this study, our objective was to define the usefulness of technetium-99m hexamethyl propylene amine oxime (Tc-99m HMPAO)-labeled leukocyte scintigraphy at three different time points in the assessment of disease extension and severity in patients with active ulcerative colitis (UC). Methods Twenty-one consecutive patients (10 women, 11 men; mean age 42.4 ± 12 years) with active UC were prospectively studied. All patients were diagnosed by colonoscopy and histopathology prior to inclusion. Scintigraphy was performed at 1 h, 2 h, and 4 h after Tc-99m HMPAO-labeled leukocyte injection. Clinic-biochemical activity score, total colonoscopic activity score, and total scintigraphic activity score at 1 h, 2 h, and 4 h were calculated for each patient. Results Sensitivity, specificity, and accuracy values of Tc-99m HMPAO-labeled leukocyte scintigraphy were calculated as follows, respectively: 1 h imaging 86%, 73%, and 83%; 2 h imaging 89%, 74%, and 86%; 4 h imaging 90%, 58%, and 83% in the detection of active inflammatory segments. Even though no statistically significant difference was found between 1 h, 2 h, and 4 h imaging with respect to the sensitivity, specificity of labeled leukocyte scintigraphy, the largest area under the curve value was found for 2 h imaging. Conclusions Tc-99m HMPAO-labeled leukocyte scintigraphy has been found to be correlated well with colonoscopy in the assessment of both the extension and severity of UC. We recommend 2 h scintigraphic imaging because it provides the largest area under the curve value and decreases the number of false-positive results.