Scintigraphy with ^99mTc-HMPAO Labeled Leukocytes in Acute Cholecystitis

Abstract

99mTc-HMPAO labeled leukocyte scanning was performed on 38 patients with clinically suspected acute cholecystitis (AC) to evaluate its diagnostic value. The typical finding was an increasing accumulation of the tracer in the gallbladder wall in a 4 hour series of scintigrams. Leukocyte scan was positive in 16 of 17 patients with surgically and histologically confirmed AC. There were no falsepositive findings. The sensitivity, specificity, and accuracy of scintigraphy were 94, 100, and 96%, respectively. In 2 patients with acute acalculous cholecystitis true-positive findings were observed. Scintigraphy with 99mTc-HMPAO labeled leukocytes is a valuable new imaging method in AC.

Use of 99mTc-mononuclear leukocyte scintigraphy in nosocomial fever

“…The introduction of SPECT/CT and PET/CT contributed greatly to solving this problem. KEIDER et al (13) studying diabetic feet with 18 F-FDG PET/CT correctly localized infection in eight bones and in five soft-tissue infection sites, whereas one site defined as infection on PET, was localized and defined by PET/CT as diabetic osteoarthropathy. Unfortunately, PET and PET/CT are still not generally available.…”

“…Scintigraphy using 111 In-granulocyte-oxine and 99m Tc-HMPAO-leukocyte is a well-established imaging technique for visualizing infection and chronic inflammatory bowel disease (1,3,4,12,14,(18)(19)(20). Used for suspected intra-abdominal abscess, osteomyelitis, vascular prosthesis infection, or chronic inflammatory bowel disease, 111 In-granulocyte and 99m Tc-HMPAO-leukocyte scintigraphs are highly sensitive and specific (1,3,4,12,14,(18)(19)(20). These techniques are often performed on patients with fevers of unknown origin, defined as patients with more than 3 weeks of illness and fever higher than 38.3˚C documented on several occasions, and no diagnostic clue despite 1 week of intensive inpatient investigation (14,16).…”

Nuclear Medicine Tests for Acute Gastrointestinal Conditions

“…71 Tc-99m-labeled white cell imaging is faster 126 and demonstrated promising sensitivity and specificity for AC-94% and 100%, respectively. 127 Imaging inflammation directly in ACC and particularly in AAC may be revisited when faster in vivo radiolabeling of leukocytes becomes available. There are few reports of increased GB uptake on F-18 FDG-PET/CT in cases with AC, [128][129][130] but this approach lacks substantive literature evidence.…”