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Appendicitis: evaluation by Tc-99m leukocyte scan.

P L Henneman1, C S Marcus, J A Butler

  • 1Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance 90509.

Annals of Emergency Medicine
|February 1, 1988
PubMed
Summary
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A new technetium-99m-albumin colloid white blood cell (TAC-WBC) scan aids appendicitis diagnosis. This imaging tool shows high accuracy, particularly for men, and is valuable when the diagnosis is uncertain.

Area of Science:

  • Nuclear Medicine
  • Diagnostic Imaging
  • Surgical Pathology

Background:

  • Diagnosing appendicitis can be challenging, necessitating accurate and timely imaging techniques.
  • Current diagnostic methods may have limitations in specific patient populations or emergent situations.

Purpose of the Study:

  • To evaluate the efficacy of a novel technetium-99m-albumin colloid white blood cell (TAC-WBC) scan for diagnosing appendicitis.
  • To determine the sensitivity, specificity, and predictive values of the TAC-WBC scan in a cohort of patients with suspected appendicitis.

Main Methods:

  • A technetium-99m-albumin colloid white blood cell (TAC-WBC) scan was performed on 100 patients with suspected appendicitis.
  • Autologous neutrophils and macrophages were labeled with technetium-99m-albumin colloid.

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  • Scan results were analyzed for diagnostic accuracy, sensitivity, specificity, and predictive values.

    • Main Results:

    • The TAC-WBC scan demonstrated high diagnostic accuracy (92%) with a sensitivity of 89% and specificity of 92% for appendicitis.
    • The scan exhibited a high negative predictive value (97%) for both men and women and a high positive predictive value (93%) for men.
    • Diagnostic reliability was lower in women (PPV = 43%), and indeterminate scans occurred in 17% of patients.

    Conclusions:

    • The TAC-WBC scan is a valuable emergent tool for evaluating appendicitis, especially in cases of diagnostic uncertainty and for men.
    • Its high negative predictive value is beneficial for ruling out appendicitis.
    • Further refinement may be needed for optimal use in women, and it should not delay care in clear-cut cases.