Dynamic radionuclide imaging with 99mTc-sucralfate in the detection of oesophageal ulceration

A J Mearns ¹, G C Hart , J A Cox

⁰Department of Thoracic Surgery, Bradford Royal Infirmary.

Gut +

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September 1, 1989

View abstract on PubMed

Summary

Technetium-99m-labeled sucralfate effectively detects esophageal mucosal damage, correlating well with endoscopy. This nuclear medicine technique may alter endoscopy indications for gastroesophageal reflux disease.

Area Of Science

Nuclear Medicine
Gastroenterology
Diagnostic Imaging

Background

Standard esophageal scintigraphy using 99mTc-colloids has limited ability to detect esophageal mucosal damage.
Sucralfate, a mucosal protectant, can be radiolabeled for improved diagnostic capabilities.

Purpose Of The Study

To evaluate the efficacy of 99mTc-sucralfate scintigraphy in detecting esophageal mucosal ulceration.
To assess the correlation between 99mTc-sucralfate imaging and endoscopic findings.
To explore the potential of this method in managing gastroesophageal reflux disease.

Main Methods

Patients underwent two supine swallows of 10 MBq 99mTc-colloid, followed by a single supine swallow of 30 MBq 99mTc-sucralfate.
Dynamic scintigraphic data were processed for time-activity curves, mean transit times, and condensed images.
Erect sucralfate images were obtained post-dynamic sequence.

Main Results

99mTc-sucralfate imaging revealed residual activity in the esophagus at ulcer sites, unlike colloid scans.
Dynamic 99mTc-sucralfate images showed excellent correlation with endoscopy findings in 62 patients.
Sequential studies demonstrated good correlation for assessing ulcer healing.

Conclusions

99mTc-sucralfate scintigraphy is a reliable method for detecting esophageal ulceration.
This nuclear imaging technique shows promise in potentially modifying the need for endoscopy in gastroesophageal reflux disease management.

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