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Assessment of inflammatory bowel disease by using two different (99m)Tc leucocyte labelling methods
V N Cardoso1, P J L Plaza, M Roca
1Faculdade de Farmacia, Universidade Federal de Minas Gerais (UFMG), Capes, Brazil.
Insights
Hanks
Area of Science:
- Nuclear Medicine
- Gastroenterology
- Immunology
Background:
- Inflammatory Bowel Disease (IBD) diagnosis relies on accurate imaging.
- White blood cell (WBC) scintigraphy is a key diagnostic tool for IBD.
- Optimizing WBC labeling media is crucial for diagnostic accuracy.
Purpose of the Study:
- To compare the diagnostic accuracy of technetium-99m hexamethylpropyleneamine oxime (99mTc-HMPAO) WBC scintigraphy.
- To evaluate two different leukocyte resuspension media: leukocyte-poor plasma (LPP) and Hanks' balanced salt solution (HBSS).
- To determine the optimal medium for WBC labeling in suspected active IBD.
Main Methods:
- Retrospective analysis of 58 patients with suspected active IBD.
- Leukocytes labeled with 99mTc-HMPAO using either LPP or HBSS as resuspension media.
- Scintigraphic imaging performed at 30 minutes and 2 hours post-injection.
Main Results:
- Leukocyte labeling efficiency was significantly higher with HBSS (89.0%) compared to LPP (65.5%).
- Diagnostic accuracy was comparable between LPP and HBSS groups.
- Sensitivity was slightly higher in the HBSS group for detecting active IBD.
Conclusions:
- Leukocyte scintigraphy using HBSS as the resuspension medium is recommended as a preferred method for WBC labeling.
- HBSS offers improved labeling efficiency and potentially higher sensitivity for IBD diagnosis.
- This finding supports the optimization of WBC scintigraphy protocols for enhanced IBD detection.
Abstract:
The aim of this study was to retrospectively compare the diagnostic accuracy of (99m)Tc hexamethylpropyleneamine oxime (HMPAO) white blood cell scintigraphy in patients with a suspicion of active inflammatory bowel disease by using two different cell suspension media: leukocyte poor plasma (LPP) and Hanks' balanced salt solution (HBSS). Leukocytes from 30 patients were labelled using LPP and in 28 cases using HBSS. In the LPP method the leukocytes were resuspended in 0.5 ml cell-free plasma while in the HBSS method the cells were resuspended in 0.5 ml HBSS. Scintigraphic images were obtained at 30 min and 2 h after injection of 185-200 MBq (99m)Tc-HMPAO leukocytes. The leukocyte labelling efficiency was 65.5% and 89.0%, respectively, for the LPP and HBSS methods. There were 22 true positive, seven true negative and one false negative result in the LPP group, while in the HBSS group results were 18, nine and one, respectively. Diagnostic accuracy was similar with both methods although sensitivity was slightly higher in the HBSS group. In summary, these date indicate that leukocyte scintigraphy labelling using HBSS as the resuspension medium should be used as a first option for white blood cell labelling and diagnosis of inflammatory bowel disease.