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Indium-111-leukocyte imaging in acute cholecystitis
D Fink-Bennett1, K Clarke, D Tsai
1Nuclear Medicine Department, William Beaumont Hospital, Royal Oak, Michigan 48073-6769.
Summary
This study found that both technetium-99m-iminodiacetic derivative (IDA) and indium-111-white blood cell (WBC) imaging accurately detect acute cholecystitis. Indium-111-WBC imaging shows inflammatory infiltrate, offering a valuable diagnostic alternative.
Area of Science:
- Nuclear Medicine
- Diagnostic Imaging
- Gastroenterology
Background:
- Acute cholecystitis diagnosis often relies on technetium-99m-iminodiacetic derivative (IDA) scintigraphy.
- Alternative imaging methods are being explored for improved accuracy and specificity.
Purpose of the Study:
- To evaluate the efficacy of sequential indium-111-white blood cell (WBC) and 99mTc-IDA imaging in diagnosing acute cholecystitis.
- To determine if 111In-WBCs accumulate in inflamed gallbladder walls, serving as an alternative to 99mTc-IDA.
Main Methods:
- Sequential scintigraphy using 99mTc-IDA and 111In-WBC was performed on eleven patients with suspected acute cholecystitis.
- Surgical confirmation was used to validate imaging findings.
Main Results:
- Both 99mTc-IDA and 111In-WBC scintigraphy demonstrated high accuracy in detecting acute cholecystitis (86% sensitivity, 100% specificity).
- 99mTc-IDA identified cystic duct obstruction, while 111In-WBC imaging detected inflammatory infiltration in the gallbladder wall.
- One patient had a false-negative 99mTc-IDA scan but a true-positive 111In-WBC scan.
Conclusions:
- Both 111In-WBC and 99mTc-IDA scintigraphy are accurate methods for diagnosing acute cholecystitis.
- 111In-WBC imaging provides complementary information by visualizing inflammatory infiltrates, potentially serving as a reliable alternative in specific cases.