Detection of esophageal ulcerations with technetium-99m albumin sucralfate

Technetium-99m albumin-sucralfate ([99mTc]Su) can be used to demonstrate peptic ulcer disease in man and animals. We evaluated the usefulness of [99mTc]Su for detecting various grades of esophagitis. [99mTc]Su adhered to the distal esophagus for up to 3 hr in five of six patients with esophageal ulcers but adhered to only two of nine with lesser degrees of esophagitis. No adherence was seen in five patients without esophagitis. Thus, [99mTc]Su may not be useful for detecting any but the most severe grade of esophagitis. Based on these results, we speculate that the previously documented beneficial effects of sucralfate on mild to moderate esophagitis may be due to other mechanisms besides adherence to the ulcerated mucosa.