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P170. Planar radiolabelled white cell scintigraphy and Technetium-99m-HMPAO labeled leukocyte single photon emission computed tomography (SPECT) for assessing endoscopic remission in ulcerative colitis

C. Arajol1, O. Puig Calvo2, F. Rodríguez-Moranta1, L. Rodríguez-Alonso1, A. Ruiz-Cerulla1, T. Lobatón1, A. López-Garcia1, J. Martín-Comín2, J. Guardiola-Capón1, 1Bellvitge University Hospital, Gastroenterology, Barcelona, Spain, 2Bellvitge University Hospital, Nuclear Medicine, Barcelona, Spain

Background

In ulcerative colitis (UC) the endoscopic remission is considered a valuable goal of therapy. In UC, scintigraphy with radiolabeled leukocytes has been used for the assessment of the extension and activity of the disease. SPECT is a technique that could have advantages over scintigraphy with radiolabeled leukocytes; however, the role of SPECT in UC is not clearly established.

The aim of the present study is to determine the accuracy of the scintigraphy with radiolabeled leukocytes and SPECT for the prediction of the endoscopic remission in patients with UC.

Methods

Prospective observational study. A scintigraphy with radiolabeled leukocytes and a SPECT were performed on 29 UC patients consecutively referred for a clinically indicated colonoscopy. The colon was divided into four segments (ascending colon, transverse colon, descending colon and rectosigma). The endoscopic activity was evaluated in each segment using the Mayo endoscopic subscore. Endoscopic remission was defined as a Mayo endoscopic subscore grade 0 or 1. The intensity of the activity in scintigraphy and SPECT were gradated in each segment on a scale between 0 and 4. The segment with the highest score was used for the analysis of predicting endoscopic remission.

Results

Endoscopic remission was observed in 13/29 cases (44.8%). The accuracy of the scintigraphy with radiolabeled leukocytes for the prediction endoscopic remission was: sensibility 85%, specificity 69%, VPP 69%, VPN 85%, global value 76%. The accuracy of the SPECT for the prediction endoscopic remission was: sensibility 69.2%, specificity 81.3%, VPP 75%, VPN 76% and global value 76%. The area under de curve was de 0.83 for the scintigraphy with radiolabeled leukocytes and 0.78 for the SPECT.

Conclusion

Scintigraphy with radiolabeled leukocytes and SPECT may be both useful for the prediction of endoscopic remission in UC. Scintigraphy is more sensitive and less specific than SPECT for this purpose.