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.
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Sellink J, Miller R: Radiology of the Small Bowel: Modern Enteroclysis Technique and Others. Nijhoff, The Hague, 1982
Best WR, Becktel JM, Singelton JW, Kern F Jr: Development of a Crohn's disease activity index. Gastroenterology 70:439–444, 1976
Segal AW, Munro JM, Ensell J, Sarner M: Indium-111 tagged leukocytes in the diagnosis of inflammatory bowel disease. Lancet II:230–232, 1981
Schölmerich J, Schmidt E, Schümichen C, Billman P, Schmidt H, Geroc W: Scintigraphic assessment of bowel involvement and disease activity in Crohn's disease using technetium-99m hexamethyl propylene amine oxime as leukocyte label. Gastroenterology 95:1287–1293, 1988
Seybold K, Locher JT, Coosemans C, Andres RY, Schubiger PA, Blauenstein P: Immunoscintigraphic localisation of inflammatory lesions: clinical experience. Eur J Nucl Med 13:587–593, 1988
Segarra I, Roca M, Baliellas C, Vilar L, Ricart Y, Mora J, Puchal R, Martin-Comin J: Granulocyte-specific monoclonal antibody technetium-99-BW 250/183 and indium-111 oxine labeled leukocyte scintigraphy in inflammatory bowel disease. Eur J Nucl Med 18:715–719, 1991
Solanki KK, Mather SJ, Janabi MA, Britton KE: A rapid method for the preparation of 99Tcm hexametazime-labeled leucocytes. Nucl Med Commun 9:753–761, 1988
Ballinger JR, Reid RM, Gullenchyn KY: Radiochemical purity of 99mTc-HMPAO. J Nucl Med 29:572–573, 1988
Thakur ML, Lavender JP, Arnot RN, Silvester DJ, Segal AW: 111-In labeled autologous leukocytes in man. J Nucl Med 18:1012–1019, 1977
Peters AM, Danpure HJ, Osman S, Hawker RJ, Henderson BL, Hodgson HJ, Kelly JD, Neirinckx RD, Lavender JP: Clinical experience with 99mTc-hexamethylpropyleneaminoxime for labeling leukocytes imaging inflammation. Lancet II:946–949, 1986
Stein DT, Gray GM, Gregory PB, Anderson M, Goodwin DA, McDougall IR: Location and activity of ulcerative and Crohn's colitis by indium 111 leukocyte scan. Gastroenterology 84:388–393, 1983
Crama-Bochbouth GE, Pena AS, Arndt JW, Tjon RTO, Tham A, Verspaget HW, Weterman IT, Pauwels EKJ, Lamers CBHW: Value of indium-111 tropolonate autologous granulocyte scintigraphy in assessment of inflammatory bowel disease. Scand J Gastroenterol 25(suppl 178):93–98, 1990
Saverymuttu SH, Camilleri M, Rees H, Lavender JP, Hodgson HJF, Chadwick VS: Indium 111-granulocyte scanning in the assessment of disease extent and disease activity in inflammatory bowel disease. Gastroenterology 90:1121–1128, 1986
Almer L, Franzén L, Peters AM, Tjadermo M, Ekberg S, Granerus G, Ström M: Do technetium-99m hexamethylpropylene amine oxime-labeled leukocytes truly reflect the mucosal inflammation in patients with ulcerative colitis? Scand J Gastroenterol 27:1031–1038, 1992
Lantto E, Jarvi K, Krekela I, Lantto T, Taavitsainen M, Vedenkangas H, Vorne M: Technetium-99-m hexamethyl propylene amine oxine leukocytes in the assessment of disease activity in inflammatory bowel diseases. Eur J Nucl Med 19:14–18, 1992
Allen RA, Sladen GE, Bassingham S, Lazarus C, Clarke SEM, Fogelman I: Comparison of simultaneous99mTc-HMPAO and111In oxine labeled white cell scans in the assessment of inflammatory bowel disease. Eur J Nucl Med 20:195–200, 1993
Arndt JW, van der Sluys Veer A, Blok D, Griffioen G, Verspaget HV, Lamers CBHW Pauwels EKJ: Prospective comparative study of technetium-99m WBCs and indium-111-granulocytes for examination of patients with inflammatory bowel disease. J Nucl Med 34:1052–1057, 1993
Gibson P, Lichtenstein M, Salehi N, Hebbard G, Andrews J: Value of positive technetium-99m leukocyte scans in predicting intestinal inflammation. Gut 32:1502–1507, 1991
Becker W, Fischbach W, Weppler M, Mosl B, Jacoby G, Börner W: Radiolabeled granulocytes in inflammatory bowel disease: Diagnostic possibilities and clinical indications. Nucl Med Commun 9:693–701, 1988
Weeler JG, Slack NF, Duncan A, Palmer M, Harvey RF:99Tcm-nanocolloid imaging in inflammatory bowel disease. Nucl Med Commun 11:127–133, 1990
Arndt JW, van der Sluys Veer A, Blok D, Griffioen G, Verspaget HV, Pena AS, Lamers CBHW Pauwels EKJ: A prospective comparison of 99m-Tc-labeled polyclonal human immunoglobulin and 111-In granulocytes for localization of inflammatory bowel disease. Acta Radiol 33:140–144, 1992
Buchegger F, Schreyer M, Carel S, Mach J-P: Monoclonal Antibodies identify a CEA crossreacting antigen of 95 kD (NCA-95) distinct in antigenivity and tissue distribution from the previously described NCA of 55 kD. Int J Cancer 33:643–649, 1984
Lind P, Langsteger W, Költringer P, Dimai HP, Passl R, Eber O: Immunoscintigraphy of inflammatory process with a technetium-99m-labeled monoclonal antigranulocyte antibody (MAb BW 250/183). J Nucl Med 31:417–423, 1990
Mahida YR, Perkins AC, Frier M, Wastie ML, Hawkey CJ: Monoclonal antigranulocyte antibody imaging in inflammatory bowel disease: a preliminary report. Nucl Med Commun 13:330–335, 1992
Sciarretta G, Furno A, Mazzoni M, Basile C, Malaguti P: Technetium-99m hexamethyl propylene amine oxime granulocyte scintigraphy in Crohn's disease: Diagnostic and clinical relevance. Gut 34:1364–1369, 1993
Ivancevic V, Munz DL: Nonspecific bowel activity in99Tcm-labeled monoclonal anti-granulocyte antibody imaging. Nucl Med Commun 13:899–900, 1992
Joseph K, Höffken H, Bosslet K, Schorlemmer HU: Imaging of inflammation with granulocytes labeledin vivo. Nucl Med Commun 9:763–769, 1988
Perkins AC, Frier M, Mahida YR, Wastie ML, Baum RP:99Tcm-antigranulocyte-antibody in the detection of inflammatory bowel disease. Nucl Med Commun 12:263, 1991 (abstract)
Becker WS, Saptogino A, Wolf FG: The single late99Tcm granulocyte antibody scan in inflammatory disease. Nucl Med Commun 13:186–192, 1992
Shawler DL, Bartholomew RM, Smith LM, Dillman RO: Human immune response to multiple injections of murine monoclonal IgG. J Immunol 135:1530–1535, 1985
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Papós, M., Nagy, F., Nárai, G. et al. Anti-granulocyte immunoscintigraphy and [99mTc]hexamethylpropyleneamine-oxime-labeled leukocyte scintigraphy in inflammatory bowel disease. Digest Dis Sci 41, 412–420 (1996). https://doi.org/10.1007/BF02093837
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DOI: https://doi.org/10.1007/BF02093837