Abstract
Purpose
Whole-body gamma camera counting is an alternative to faecal 111In collection for quantifying disease activity in inflammatory bowel disease (IBD) but requires administration of imaging activities of 111In. The aim of this study was to explore a dedicated whole-body counter which requires 20-fold less activity than gamma camera counting.
Methods
Thirty patients with known or suspected IBD received 99mTc-granulocytes (∼200 MBq) and 111In-granulocytes (∼0.5 MBq). The 99mTc-cells were injected 45 min after the 111In-cells and immediately after a baseline 111In whole-body count. The decay-corrected count at 120 h was expressed as a fraction of baseline to give whole-body 111In retention (WBR). One patient was excluded as the injected cells were non-viable.
Results
Median 45-min intravascular 111In recovery was 35% in patients compared with 43% in six normal volunteers (p<0.05). WBR in normals ranged from 91% to 93% and in 11 patients with negative 99mTc imaging from 87% to 96%. Only one of 11 patients with negative imaging had WBR <90% while 11/12 patients with WBR <90% had abnormal imaging. Ten of 13 patients with Crohn’s disease (CD) had abnormal imaging. The lowest WBR in these ten was 77% and six had values of >90%. There was a significant association between WBR and 99mTc image grade (Rs=0.73, p<0.002) in 16 patients without CD, but not in 13 patients with CD (Rs=0.54, p>0.05).
Conclusion
Dedicated whole-body counting is able to quantify disease activity in IBD but may give normal values in active CD.
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References
Saverymuttu SH, Peters AM, Hodgson HJ, Chadwick VS, Lavender JP. Indium-111 autologous leucocyte scanning: comparison with radiology for imaging the colon in inflammatory bowel disease. Br Med J 1982;285:255–7.
Scholmerich J, Schmidt E, Schumichen C, Billmann P, Schmidt H, Gerok W. Scintigraphic assessment of bowel involvement and disease activity in Crohn’s disease using technetium 99m-hexamethyl propylene amine oxine as leukocyte label. Gastroenterology 1988;95:1287–93.
Arndt JW, van der Sluys Veer A, Blok D, Griffoen G, Verspaget HW, Lamers CB, Pauwels EK. Prospective comparative study of technetium-99m-WBCs and indium-111-granulocytes for the examination of patients with inflammatory bowel disease. J Nucl Med 1993;34:1052–7.
Peters AM, Danpure HJ, Osman S, Hawker RJ, Henderson BL, Hodgson HJ, et al. Preliminary clinical experience with Tc-99m-HMPAO for labelling leucocytes and imaging inflammation. Lancet 1986;2:946–9.
Mansfield JC, Giaffer MH, Tindale WB, Holdsworth CD. Quantitative assessment of overall inflammatory bowel disease activity using labelled leucocytes: a direct comparison between indium-111 and technetium-99m HMPAO methods. Gut 1995;37:679–83.
Saverymuttu SH, Peters AM, Hodgson HJ, Chadwick VS, Lavender JP. Quantitative faecal 111-indium leucocyte excretion in the assessment of disease activity in Crohn’s disease. Gastroenterology 1983;85:1333–9.
Saverymuttu SH, Peters AM, Keshavarzian A, Reavy HJ, Lavender JP. The kinetics of 111-indium distribution following injection of 111-indium labelled autologous granulocytes in man. Br J Haematol 1985;61:675–85.
Saverymuttu SH, Peters AM, Hodgson HJ, Chadwick VS. Assessment of disease activity in ulcerative colitis using 111-indium labelled leucocyte faecal excretion. Scand J Gastroenterol 1983;18:907–12.
Fischbach W, Becker W. Clinical relevance of activity parameters in Crohn’s disease estimated by the faecal excretion of 111In-labeled granulocytes. Digestion 1991;50:149–52.
Currie DC, Saverymuttu SH, Peters AM, Needham SG, George P, Dhillon DP, et al. Indium-111 labelled granulocyte accumulation in respiratory tract of patients with bronchiectasis. Lancet 1987;1:1335–9.
Currie DC, Peters AM, Garbett ND, George P, Strickland B, Lavender JP, Cole PJ. In-111 labelled granulocyte scanning to detect inflammation in the lungs of patients with chronic sputum expectation. Thorax 1990;45:541–4.
Carpani de Kaski M, Peters AM, Knight D, Stuttle AWJ, Lavender JP, Hodgson HJ. In-111 whole body retention: a new method for quantification of disease activity in inflammatory bowel disease. J Nucl Med 1992;33:756–62.
Hayball MP, Dendy PP. Baseline levels of total-body radioactivity determined by whole body monitoring. Radiat Prot Dosimetry 1991;36:93–6.
Peters AM, Saverymuttu SH, Reavy HJ, Danpure HJ, Osman S, Lavender JP. Imaging inflammation with 111indium tropolonate-labeled leucocytes. J Nucl Med 1983;24:39–44.
Carpani de Kaski M, Peters AM, Lavender JP, Hodgson HJF. Fluticasone propionate in Crohn’s disease. Gut 1991;32:657–61.
Chisholm PM, Danpure HJ, Healey G, Osman S. Cell damage resulting from the labeling of rat lymphocytes and HeLa S3 cells with In-111 oxine. J Nucl Med 1979;20:1308–11.
Dancey JT, Deubelbeiss KA, Harker LA, Finch CA. Neutrophil kinetics in man. J Clin Invest 1976;58:705–15.
Peters AM, Roddie ME, Danpure HJ, Osman S, Zacharopoulos GP, George P, et al. Tc-99m HMPAO labelled leucocytes: comparison with In-111-tropolonate labelled granulocytes. Nucl Med Commun 1988;9:449–63.
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We are grateful to GlaxoSmithKline for financial support.
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Cheow, H.K., Voutnis, D.D., Evans, J.W. et al. Quantification of disease activity in patients undergoing leucocyte scintigraphy for suspected inflammatory bowel disease. Eur J Nucl Med Mol Imaging 32, 329–337 (2005). https://doi.org/10.1007/s00259-004-1617-7
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DOI: https://doi.org/10.1007/s00259-004-1617-7