open access

Vol 22, No 2 (2019)
Original articles
Published online: 2019-07-31
Submitted: 2019-01-09
Accepted: 2019-06-24
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Scintigraphy with 99mTc-HMPAO labeled leukocytes is still an accurate and convenient tool to rule out suspected inflammatory bowel disease in children

Daniela Chroustová, Nabil El-Lababidi, Jiří Trnka, Linda Černa, Lukáš Lambert
DOI: 10.5603/NMR.2019.0017
·
Pubmed: 31482559
·
Nucl. Med. Rev 2019;22(2):69-73.

open access

Vol 22, No 2 (2019)
Original articles
Published online: 2019-07-31
Submitted: 2019-01-09
Accepted: 2019-06-24

Abstract

BACKGROUND: Abdominal pain is a common complaint in children and its differential diagnosis includes inflammatory bowel

disease (IBD). The aim of the study was to assess the diagnostic accuracy of scintigraphy with 99mTechnetium Hexamethylpropyleneamine

Oxime (99mTc-HMPAO) labeled leukocytes in children with suspected IBD.

MATERIAL AND METHODS: Eighty-five children (age 12.4 ± 4.3 years, 47% boys) with suspected IBD based on clinical presentation, laboratory and ultrasound findings underwent scintigraphy with 99mTc-HMPAO labeled leukocytes. Abdominal scintigrams were acquired 40 min and 90 min post injection, and whole body scintigrams at 180 min. Scintigraphy was evaluated by two specialists in nuclear medicine. The results were compared with the final diagnosis established by endoscopy, histology, other imaging methods, and follow-up evaluated by an expert in pediatric gastroenterology.

RESULTS: Scintigraphy results corresponded with the final diagnosis in 78 (91%) patients resulting in a sensitivity of 89% (95%CI 72 to 98%), specificity of 91% (95% CI 82 to 98%), and accuracy of 91% (95% CI 83 to 96%). The interobserver agreement was 0.82 (95% CI 0.75 to 0.88) and the radiation dose estimate was 4.2 ± 1.5 mSv. In 28 children (25 positives and 3 negatives on scintigraphy), the diagnosis of IBD was established by endoscopy, histology, MR enterography, or fluoroscopy. Five positive findings on scintigraphy were not confirmed by other methods or during follow-up.

CONCLUSION: Scintigraphy with 99mTc-HMPAO labeled leukocytes in children with suspected IBD has high accuracy and offers a non-invasive option for detecting the presence of gastrointestinal inflammation. Scintigraphy is a powerful non-invasive decision-making tool in the management of suspected IBD that may spare a greater proportion of children of more invasive and demanding examinations.

Abstract

BACKGROUND: Abdominal pain is a common complaint in children and its differential diagnosis includes inflammatory bowel

disease (IBD). The aim of the study was to assess the diagnostic accuracy of scintigraphy with 99mTechnetium Hexamethylpropyleneamine

Oxime (99mTc-HMPAO) labeled leukocytes in children with suspected IBD.

MATERIAL AND METHODS: Eighty-five children (age 12.4 ± 4.3 years, 47% boys) with suspected IBD based on clinical presentation, laboratory and ultrasound findings underwent scintigraphy with 99mTc-HMPAO labeled leukocytes. Abdominal scintigrams were acquired 40 min and 90 min post injection, and whole body scintigrams at 180 min. Scintigraphy was evaluated by two specialists in nuclear medicine. The results were compared with the final diagnosis established by endoscopy, histology, other imaging methods, and follow-up evaluated by an expert in pediatric gastroenterology.

RESULTS: Scintigraphy results corresponded with the final diagnosis in 78 (91%) patients resulting in a sensitivity of 89% (95%CI 72 to 98%), specificity of 91% (95% CI 82 to 98%), and accuracy of 91% (95% CI 83 to 96%). The interobserver agreement was 0.82 (95% CI 0.75 to 0.88) and the radiation dose estimate was 4.2 ± 1.5 mSv. In 28 children (25 positives and 3 negatives on scintigraphy), the diagnosis of IBD was established by endoscopy, histology, MR enterography, or fluoroscopy. Five positive findings on scintigraphy were not confirmed by other methods or during follow-up.

CONCLUSION: Scintigraphy with 99mTc-HMPAO labeled leukocytes in children with suspected IBD has high accuracy and offers a non-invasive option for detecting the presence of gastrointestinal inflammation. Scintigraphy is a powerful non-invasive decision-making tool in the management of suspected IBD that may spare a greater proportion of children of more invasive and demanding examinations.

Get Citation

Keywords

scintigraphy; 99mTc-HMPAO; leukocyte; inflammatory bowel disease

About this article
Title

Scintigraphy with 99mTc-HMPAO labeled leukocytes is still an accurate and convenient tool to rule out suspected inflammatory bowel disease in children

Journal

Nuclear Medicine Review

Issue

Vol 22, No 2 (2019)

Pages

69-73

Published online

2019-07-31

DOI

10.5603/NMR.2019.0017

Pubmed

31482559

Bibliographic record

Nucl. Med. Rev 2019;22(2):69-73.

Keywords

scintigraphy
99mTc-HMPAO
leukocyte
inflammatory bowel disease

Authors

Daniela Chroustová
Nabil El-Lababidi
Jiří Trnka
Linda Černa
Lukáš Lambert

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