Is it possible to assess disease activity of inflammatory bowel disease with scintigraphy

Abstract 99m Tc-HMPAO-leukocyte scintigrams were compared with the activity index (AI) of Van Hees in 145 inflammatory bowel disease (IBD) patients. Labelling of leukocytes with 99m Tc-HMPAO was less time-consuming and less laborious than 111 In-labelling of granulocytes; in addition, the radiation dose for the patient is lower and the shorter acquisition time allows multiple views. In a previous comparative study 99m Tc-leukocytes proved superior to 111 In-granulocytes in detecting active IBD. The present study shows that a positive AI (> 125) is associated with a positive 99m Tc-leukocyte scintigram (40 pts); a negative 99m Te-leukocyte scintigram is only found in patients with a negative AI (27 pts). In 30 out of 78 patients with an AI (> 125) and a positive scintigram these positive results were confirmed by radiological and/or endoscopic examinations, but in the remaining 48 patients verification of the scintigraphic result was prohibited due to to the absence of other confirmative examinations within 1 month of scintigraphy. In our view 99m Tc-leukocyte scintigraphy may well be the gold standard for functional assessment of inflammation intensity and localization in IBD patients.