Is 99mTc-LeucoScan scintigraphy useful in the assessment of location in Crohn's disease?

Abstract

Background/Aims: Scintigraphy with 99mTechnetium HMPAO labelled whitw blood cells (99mTC HMPAO-WBC) is routinely used for the assessment of inflammatory bowel disease (IBD). The main disadvantages of this diagnostic test, are the time consuming in vitro cell labelling and the handling of blood Itself. To overcome these problem, new, equally effective agents are under development. To assess the value of a new easily prepared agen, the 99mTc-Leucoscan, in IBD, we performed a pilot scintigraphic study in patients with active Crohn's disease (CD). In the event of negaative results, it was envisaged, that another agent 99mTc (V) dimercaptosuccinic acid (DMSA) would be tested. Patients - Method: We performed 99mTc-Leucoscan scintigraphy in 7 patients with clinically active CD and in 3 of them an additional scintigraphy, th 99mTc (V) DMSA. Two of the 7 patients were males and 5 females; aged 26-70 years (mean age 42 years). Two of them had extra-intestinal manifestations with joint involvement. Results: In one of these patients 99mTc-Leucoscan scintigraphy was considered as indetermenate because of relatively increased uptake in the bowel and in the other 6 it was false negative. In the 2 patients with joint involvement 99mTc-Leucoscan images did show increased uptake in the involved bone areas. Three of all patients subsequently underwent 99mTc (V) DMSA scintigraphy and all 3 were considered true positive. Conclusion: Our study concludes that 99mTc-Leucoscan scintigraphy has no place in the assessment of gastrointestinal inflammation in CD. 99mTc (V) DMSA could be suggested as a reliable tracer that could substitute for 99mTc-HMPAO WBC scintigraphy in IBD patients.