Technetium-99m HMPAO-Labeled Leukocyte Imaging Compared with Endoscopy, Ultrasonography, and Contrast Radiology in Children with Inflammatory Bowel Disease

Alberini, Jean-Louis; Badran, A; Fréneaux, E; Hadji, Sara El; Kalifa, G.; Devaux, J Y; Dupont, T

doi:10.1097/00005176-200103000-00009

Cited by 41 publications

(25 citation statements)

References 42 publications

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“…However, when results were separately calculated for the Crohn's Disease patients, the specificity was lower, 63%. The specificity is lower than previously reported 11,[42][43][44] and probably reflects the small number of patients without macroscopic findings in our cohort, implying a selection bias. Since this is the first study of leukocyte scintigraphy compared with complete endoscopic evaluation of the small bowel, our results should be considered more reliable than studies using indirect methods to demonstrate inflammation.…”

Section: Discussioncontrasting

confidence: 93%

“…43,45 Several studies in children have shown results comparable to those in adults. 10,11,46 A more widespread use of leukocyte scanning can be advocated inasmuch as the method is noninvasive, without the need for bowel preparation, and, in comparison to other explorations, preferred by patients. 6 Capsule endoscopy is an emerging technique for the detection of small bowel Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

“…Small bowel enteroscopy is difficult to perform, uncomfortable for the patient, and available only at a few centers. Leukocyte scintigraphy might be of special value in assessing small bowel inflammation in Crohn's disease 11 and it may reveal lesions that are inaccessible to classic investigations. 12 Capsule endoscopy is a new technique that has shown promise for the diagnosis of gastrointestinal bleeding 13 and is an emerging technique for the detection of small bowel Crohn's disease.…”

mentioning

confidence: 99%

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

Almér

Granérus²,

Ström

et al. 2007

Inflammatory Bowel Diseases

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Section: Discussioncontrasting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Almér

Granérus²,

Ström

et al. 2007

Inflammatory Bowel Diseases

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“…To circumvent these disadvantages due to the nonspecific nature of 18 F-FDG uptake in the bowel, other scintigraphic techniques that target immune cells have previously been tested for imaging IBD, including polyclonal immunoglobulins and monoclonal antibodies against granulocytes and adhesion molecules (7,8,(26)(27)(28). Also 67 Ga-citrate uptake has been shown to correlate with the extent and activity of disease in both Crohn disease and ulcerative colitis (29,30).…”

Section: Discussionmentioning

confidence: 99%

^99mTc-CXCL8 SPECT to Monitor Disease Activity in Inflammatory Bowel Disease

et al. 2015

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Inflammatory bowel diseases (IBDs) are defined as chronic relapsing immune-mediated disorders of the gastrointestinal tract. IBD exacerbations are characterized by recruitment of mainly CXCL8 receptorexpressing activated neutrophils into the intestinal wall, leading to severe damage. Considering its chronic relapsing character, accurate and timely diagnosis of an exacerbation is pivotal for early adaptation of the treatment and reduction of the disease burden. However, endoscopic evaluation is invasive and associated with an increased risk of perforation. We previously developed a 99m Tc-labeled CXCL8 preparation in preclinical models including colitis and clinical studies. Methods: In this study, we investigate the accuracy of 99m Tc-CXCL8 SPECT to detect and localize disease activity in a prospective series of patients with IBD. Thirty patients (15 Crohns disease, 15 ulcerative colitis) participated, and 92 segmental pairs of histology and 99m Tc-CXCL8 scans were studied. Imaging was performed after injection of 400 MBq of 99m Tc-CXCL8. Planar and SPECT images of the abdomen were acquired at 30 min and 4 h after the injection. Results: The overall sensitivity and specificity on a per-patient basis for the detection of active disease were 95% and 44% for 99m Tc-CXCL8 scan and 71% and 70% for endoscopy. The degree of 99m Tc-CXCL8 accumulation correlated to the degree of neutrophilic influx in affected mucosa. Sensitivity and specificity on a per-segment basis, calculated from the 92 segmental pairs, were 82% and 72%, negative predictive value was 81%, and overall positive predictive value was 74%. Specificity could be increased at the expense of sensitivity using different cutoffs. In 74 segmental pairs, overall sensitivity and specificity for endoscopy were 74% and 85%, positive predictive value was 81%, and negative predictive value was 79%. Conclusion: 99m Tc-CXCL8 SPECT provides a novel imaging technique to target neutrophil recruitment to the intestinal wall, especially in moderate to severe exacerbations of IBD. Further validation studies are warranted to potentiate 99m Tc-CXCL8 SPECT as a biomarker to scale up or step down treatment with immune-modulating drugs in a personalized fashion.

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“…En cualquier caso, en estos estudios se establece que la ecografía se muestra muy sensible y especí-fica en la detección de las lesiones de colitis ulcerosa. Las cifras de precisión global se encuentran entre el 63 y el 95% (21,(26)(27)(28)(29)(30)(31)(32)(33). Esta gran variabilidad en los resultados se explica en los diferentes patrones oro empleados en estos estudios para evaluar la precisión de la ecografía (endoscopia o técnicas radiológicas), la heterogeneidad de los pacientes seleccionados y las notables diferencias en los tamaños muestrales.…”

Section: Discussionunclassified

Utilidad de la ecografía en la valoración de la extensión de la colitis ulcerosa

Ares

Cadilla

Martínez

et al. 2007

Rev. esp. enferm. dig.

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de la ecografía digestiva en la valoración de la extensión de la colitis ulcerosa. Rev Esp Enferm RESUMENIntroducción: el hallazgo de lesiones endoscópicas severas en un paciente con colitis ulcerosa desaconseja la realización de una exploración completa del colon. No obstante el conocimiento de la extensión precisa de la enfermedad tiene gran importancia en las decisiones terapéuticas a tomar y también en el pronóstico de la enfermedad. Por todo ello, la validación de una técnica no invasiva para el estudio de extensión de la colitis ulcerosa cobra gran interés e importancia.Material y método: se incluyen en el estudio pacientes con diagnóstico previo de colitis ulcerosa o en el debut de la enfermedad y, de forma prospectiva y ciega se evalúa la precisión de la ecografía digestiva en la valoración de la extensión de la colitis ulcerosa. Las exploraciones ecográficas son realizadas todas ellas por el mismo explorador y siempre con anterioridad al estudio endoscópico completo, que se usa como patrón oro. No se emplea la técnica hidrocolónica en ningún caso.Resultados: han sido incluidos en el estudio 20 pacientes, 13 varones (65%) y 7 mujeres (35%), con una edad media de 51,7 años (rango de 24 a 82 años). Los estudios endoscópicos mostraron una afectación severa en 5 casos (25%), moderada en 12 pacientes (60%) y lesiones leves en los 3 casos restantes (15%). El estudio ecográfico del colon fue considerado satisfactorio en 18 casos (90%) y la extensión de la enfermedad establecida en el estudio ecográfico coincide en todos los casos con la determinada por la colonoscopia: 3 pacientes (16,6%) presentaban una proctitis ulcerosa, 9 (50%) una colitis izquierda y 6 (33,3%) una colitis extensa.Conclusiones: la ecografía digestiva permite el estudio del marco colónico en la mayoría de los pacientes, especialmente si existe actividad inflamatoria, permitiendo establecer con gran precisión la extensión de la colitis ulcerosa, independientemente del grado de actividad de la misma.Palabras clave: Colitis ulcerosa. Diagnóstico. Extensión. Ecografía. Endoscopia. ABSTRACTIntroduction: a full examination of the colon should be avoided upon finding severe endoscopic lesions in patients with ulcerative colitis. However, knowledge of the precise extent of disease is quite important for disease prognosis and the making of therapeutic decisions. Therefore, any validation of a non-invasive technique to assess the extent of ulcerative colitis gains a lot of interest and importance.Material and method: the study included patients that were previously diagnosed of having ulcerative colitis or were beginning to suffer from the disease. A prospective and blind evaluation was carried out to determine the precision of digestive ultrasonography in assessment of ulcerative colitis extent. All ultrasonography was carried out by the same person and was always performed prior to carrying out a full endoscopic study, which is used as the gold standard. The hydrocolonic ultrasonograpy technique was not used in any of the cases.Results: a total of 2...

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Technetium-99m HMPAO-Labeled Leukocyte Imaging Compared with Endoscopy, Ultrasonography, and Contrast Radiology in Children with Inflammatory Bowel Disease

Cited by 41 publications

References 42 publications

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

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

^99mTc-CXCL8 SPECT to Monitor Disease Activity in Inflammatory Bowel Disease

Utilidad de la ecografía en la valoración de la extensión de la colitis ulcerosa

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