Assessment of inflammatory bowel disease by using two different 99mTc leucocyte labelling methods

Abstract

The aim of this study was to retrospectively compare the diagnostic accuracy of (99m)Tc hexamethylpropyleneamine oxime (HMPAO) white blood cell scintigraphy in patients with a suspicion of active inflammatory bowel disease by using two different cell suspension media: leukocyte poor plasma (LPP) and Hanks' balanced salt solution (HBSS). Leukocytes from 30 patients were labelled using LPP and in 28 cases using HBSS. In the LPP method the leukocytes were resuspended in 0.5 ml cell-free plasma while in the HBSS method the cells were resuspended in 0.5 ml HBSS. Scintigraphic images were obtained at 30 min and 2 h after injection of 185-200 MBq (99m)Tc-HMPAO leukocytes. The leukocyte labelling efficiency was 65.5% and 89.0%, respectively, for the LPP and HBSS methods. There were 22 true positive, seven true negative and one false negative result in the LPP group, while in the HBSS group results were 18, nine and one, respectively. Diagnostic accuracy was similar with both methods although sensitivity was slightly higher in the HBSS group. In summary, these date indicate that leukocyte scintigraphy labelling using HBSS as the resuspension medium should be used as a first option for white blood cell labelling and diagnosis of inflammatory bowel disease.

Leukocyte-technetium-99m uptake in Crohn’s disease: Does it show subclinical disease?

“…On the other hand, the labeling yield for leukocytes was 55.0% ± 10%. Labeling yields of 46% and 65.5% have been reported previously [19,20] . Thus, the value obtained in the present work is supported by published data, which suggests that the manipulation process utilized in the preparation of the radiolabeled cells was adequate.…”

“…Radiolabeled leukocytes in the Crohn's disease diagnostic screening of inflammatory diseases [4] . Cardoso et al [19] have observed sensitivity, specificity and accuracy values of > 87.5% in studies performed in patients highly suspected of having inflammatory bowel disease.…”

99mTc‐tricabonyl labeling of ofloxacin and its biological evaluation in Staphylococcus aureus as an infection imaging agent

“…To label the leukocyte, it is necessary to take blood from the patient, its leukocyte be separated, then labeled, and finally reinjected to the patient. This technique is time consuming, and the potential of contamination or transmission of blood‐borne pathogens to patient or technician is high . 67 Ga‐citrate is the most initial radionuclide for this propose, but unfortunately, it has several disadvantages such as long physical half‐life; high and multiple energy gamma ionizing radiation, which causes high radiation absorbed doses; lack of availability as a generator; and high sensitivity for both infection and sterile inflammation .…”