The inflammatory activity in 108 bowel segments of 40 patients with suspected or known inflammatory bowel disease was assessed macroscopically by endoscopy, histology and technetium-99m hexamethyl propylene amine oxine (99mTc-HMPAO) leucocytes using a numerical grading system (scores 0-3). A 4-h series of scintigrams showed a significant correlation with both histological and macroscopical assessment of disease activity (rho = 0.850, P less than 0.001 and rho = 0.773, P less than 0.001, respectively). Sensitivity, specificity and accuracy of scintigraphy in detecting active inflammatory segments were 85%, 92% and 89%, respectively. A normal scintigram did not completely exclude mild inflammatory activity, especially in the rectosigmoid area. 99mTc-HMPAO leucocytes offer an accurate and non-invasive alternative for the assessment of disease activity in ulcerative colitis and Crohn's disease.

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The efficiency of 99Tcm-methylene diphosphonate (MDP) and 99Tcm-dicarboxypropane diphosphonate (DPD) to detect pathologically increased bone uptake was evaluated both by computed quantitative intra-individual and visual inter-individual comparison. Twelve patients with altogether 44 metastases in ribs and lumbar vertebrae were evaluated quantitatively. The lesion to normal bone ratio (mean ± SD) was, with MDP, 2.9 ± 1.6 and with DPD 2.4 ± 1.2 (p<0.001), and the normal bone to soft tissue ratios with MDP 8.5 ± 5.0 and with DPD 9.4±6.1 (NS). Visual analysis of 162 patients with 334 focal lesions showed no significant difference between two MDP preparations and one DPD preparation. Visual and quantitative comparison in the three most common malignancies studied (breast, prostatic, and lung carcinoma) gave the same result. Because the lesion to normal bone ratios were high with both agents, and there was no significant difference on visual analysis, both radiopharmaceuticals are considered to be relevant bone seeking agents and the difference between MDP and DPD is only academic and not of practical value.

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