Clinical Usefulness of 99m-HMPAO Labelled Leukocyte SPECT in Inflammatory Bowel Disease

Abstract

Background/Aims: Exact determination of the extent of bowel involvement in

inflammatry bowel disease is essential for the evaluation of disease severity and for the

planning of approapriate therapy. The aim of the study was to determine the accuracy

of 99mTc-HMPAO(Hexamethyl Propylene Amine Oxime) labelled

leukocyte-SPECT(Single Photon Emission Computerized Tomography) in the assessment

of disease extent and disease activity in inflammatory bowel disease.

Methods: Using a scintigraphy with autologous leukocytes labelled by

99mTc-HMPAO was performed in 32 cases. In 15 patients with 9

ulcerative colitis, 6 Crohn's disease, the clinical, endoscopic and histologic disease

activities were compared with SPECT activity index, respectively.

Results: 1. 99mTc HMPAO labelled leukocyte SPECT revealed 92.6%

sensitivity, 100% specificity and 93.8% accuracy to detect of active inflammation of the

colon. 2. The correlation between clinical activity index(Rachmilewiltz), and HMPAO

SPECT activity index was very high significant(r=0.91; p<0.001), less significant(r=0.69;

p<0.01) between endoscopy and scan activity index and highly significant(r=0.89; p

<0.001) between histologic activity index and scan activity index.

Conclusions: 99mTc-HMPAO labelled leukocyte SPECT is a reliable

method to determine the extent of the bowel inflammation and disease activity in

inflammatory bowel disease.