Accumulation of leucocytes labelled with technetium-99m hexamethylpropylene amine oxime in malignant abdominal tumours

Abstract

A total of 343 leucocyte scans labelled with technetium-99m hexamethylpropylene amine oxime were reviewed that had been performed in 338 patients suspected of having abdominal infection or inflammation. There was uptake by malignant abdominal tumours in 10 cases (2.9%), which represents 62.5% of known malignancies at the time of the scintigram. Accumulation was seen in 8 patients with adenocarcinoma of the colon associated with a secondary infection in the tumour or pericolic inflammation. A large tumour that had spread beyond the bowel wall was related to a positive scintigram. Accumulation was also found twice in a malignant fibrous histiocytoma in which bleeding and an inflammatory reaction to necrosis were probably responsible for the uptake. The relevant treatment was delayed for 2 weeks-2 months in 4 patients with adenocarcinoma of the colon in whom the positive uptake was regarded as confirmation of the clinically suspected acute diverticulitis.

Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohnʼs disease

“…Early colon uptake was present in 3 controls and confined to tumor regions as previously described for both indium-111 and technetium-99m-labeled cells. 30,31 In our previous study, which included 9 noninflammed controls, we found early uptake in the small bowel in 1 control and in the colon in another. 22 Small bowel enteroscopy was not performed in that study, and the early colon uptake corresponded to a segment with mild histopathologic inflammation.…”

“…32 Nonspecific bowel activity, unrelated to inflammatory bowel disease, has in other studies been observed in the small bowel and proximal colon as early as 30 minutes after injection of technetium-99m exametazime-labeled cells 33 and been found in about 15% of subjects within the first hour. 29,34 In other series, such activity has first been seen on 2-hour images in 7% or on 3-4-hour images in 5%-28% of examinations 31,[35][36][37] or to occur only later than 3 hours. 38 We applied neither fasting conditions before scanning 39 nor injection of pethidine before the reinjection of labeled cells, 40 which has been shown to increase the frequency of gall bladder visualization from 10% to 44% and from 29% to 72%, respectively.…”

Nuclear Medicine Imaging of Infection in Cancer Patients (With Emphasis on FDG-PET)

“…There was uptake by malignant abdominal tumors in 10 cases (3%), which represented 63% of known malignancies at the time of the scintigram. The relevant treatment was delayed for 2 weeks to 2 months in four patients with adenocarcinoma of the colon in whom the positive uptake was regarded as confirmation of clinically suspected acute diverticulitis [16].…”

Radiopharmaceuticals for the Visualization of Infectious and Inflammatory Lesions

“…Since 1988 kits of HMPAO for labelling leukocytes are commercially available. 111 In labels all cell types indiscriminately, have been useful in scintigraphic detection of infected or inflammatory lesions in a number of clinical pathologies such as fever of unknown origin, pulmonary and abdominal infections, osteomyelitis, infected artificial joints, infected vascular grafts, bacterial endocarditis and inflammatory joint disorders such as rheumatoid arthritis [7, 31,32,34,[43][44][45][46][47][48]. Recently a concensus protocol has been reached by The International Society of Radiolabelled Blood Elements (ISORBE) and a uniform procedure for radiolabelling leukocytes with 99m Tc-HMPAO was published [42].…”