Anti-granulocyte immunoscintigraphy and [99mTc]hexamethylpropyleneamine-oxime-labeled leukocyte scintigraphy in inflammatory bowel disease

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Abstract
A prospective study was carried out on 13 patients with ulcerative colitis and 11 with Crohn's disease to compare the value of radioimmunoscintigraphy involving99mTc-labeled antigranulocyte monoclonal antibody (BW 250/183) with that of hexamethylpropyleneamine-oxime-labeled leukocyte scintigraphy. The extent of the process (various segments of the small bowel; ascending, transverse, and descending colon; and rectosigmoideum) was determined in 115 segments by means of radioimmunoscintigraphy and leukocyte scintigraphy and compared with the results of enteroclysis and colonoscopy in 64 segments. The scintigraphic activity, calculated by summing the segment scores, was compared with clinical and laboratory parameters. During radioimmunoscintigraphy, the 24-hr fecal excretion of the antibody was measured. The two methods revealed a different extent of the process (P<0.01). The segmental sensitivity and specificity were 63% and 96% in radioimmunoscintigraphy, and 87% and 94% in leukocyte scintigraphy. Leukocyte scintigraphy proved to be superior in cases with small intestine involvement, but the methods are of similar value in cases with large bowel involvement. The scintigraphic activity determined by radioimmunoscintigraphy and the fecal excretion of monoclonal antibody correlated with seven parameters, while that determined by leukocyte scintigraphy did so with 12 variables. Both methods are of similar value for the detection of large bowel involvement, but leukocyte scintigraphy was the better method for determination of the involved segments in the small intestine. The scintigraphic activity proved a useful parameter, correlating well with the clinical and laboratory variables.