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Prospective Comparative Study of Technetium-99m-WBCs and Indium-111-Granulocytes for the Examination of Patients with Inflammatory Bowel Disease

Departments of Diagnostic Radiology and Nuclear Medicine and Gastroenterology, University Hospital, Leiden, The Netherlands

Correspondence: For correspondence or reprints contact: J.W. Arndt, MD, Department of Diagnostic Radiology and Nuclear Medicine, Building 1, C-4Q, University Hospital, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

ABSTRACT

In a prospective comparative study of 14 patients with inflammatory bowel disease (IBD), the abilities of ^99mTc-HMPAO labeled white blood cells (WBCs) and ¹¹¹In-granulocytes to assess the presence and location of active disease were compared. The two examinations were carried out within 2 wk of each other. Scintigraphically concordant positive or discordant segments were evaluated by radiologic or endoscopic examination performed within 14 days. When bowel segments were compared, concordance was found for 102/111 (91.8%) segments between ^99mTc-WBC images obtained at 1 hr after injection and 3-hr ¹¹¹In-granulocyte images. For five of five ^99mTc-WBCs positive/¹¹¹In-granulocyte negative segments, it could be proven that the ^99mTc-WBC result was caused by active disease. For patients, ^99mTc-WBC scintigraphy detected four more patients with active disease than ¹¹¹In-granulocytes (11 and 7 patients, respectively). Technetium-WBCs was superior in the assessment of active disease, especially for small bowel segments. We conclude that early imaging 1 hr after the injection of ^99mTc-WBCs can reliably replace ¹¹¹In-granulocyte scintigraphy in IBD patients because the radiopharmaceutical is available on a daily basis. Thus, there is less radiation burden to the patient and cell separation is simpler and less time-consuming.

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