Scintigraphy with 99m-technetium HMPAO-labelled granulocytes as a diagnostic test for screening patients with a low probability of bowel inflammation: a prospective study

Abstract

Scintigraphy with pure granulocytes labelled with 99m-technetium hexamethyl propylene amine oxime (HMPAO) has been shown to be highly sensitive and specific in demonstrating active inflammation in Crohn's disease.

To use this method prospectively in patients with no or a low probability of inflammatory bowel disease to determine whether it may be used as a screening test.

Scintigraphy using pure autologous granulocytes labelled with 99m-Tc-HMPAO was performed after 30 min and 2–2.5 h in 43 patients in whom the clinical diagnosis was of suspected irritable bowel syndrome and in 48 patients with a low probability of inflammatory bowel disease.

Scintigraphy with granulocytes labelled with 99m-Tc-HMPAO proved to have a diagnostic sensitivity of 100% and an overall specificity for diseases with an inflammatory component of 95%; 90.5% in the group with a low probability of inflammatory disease. The only false-positive results occurred in rheumatic patients undergoing treatment with anti-inflammatory drugs.

If cell separation and labelling is carried out with maximum accuracy, and Scintigraphy performed after treatment with anti-inflammatory drugs has been suspended, this non-invasive test can be used to screen patients in whom there is a slight probability of inflammatory disease as a guide to more specific invasive testing.