Role of scintigraphy in inflammatory bowel disease

doi:10.3748/wjg.15.2693

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jun 14, 2009; 15(22): 2693-2700
Published online Jun 14, 2009. doi: 10.3748/wjg.15.2693

Role of scintigraphy in inflammatory bowel disease

Maria I Stathaki, Sophia I Koukouraki, Nikolaos S Karkavitsas, Ioannis E Koutroubakis

Maria I Stathaki, Sophia I Koukouraki, Nikolaos S Karkavitsas, Department of Nuclear Medicine, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece

Ioannis E Koutroubakis, Department of Gastroenterology, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece

Author contributions: Stathaki MI, Koukouraki SI reviewed the literature, wrote the first draft of the paper; Karkavitsas NS and Koutroubakis IE provided the idea, performed the review, and edited the manuscript.

Correspondence to: Ioannis E Koutroubakis, MD, PhD, Department of Gastroenterology, Medicine University Hospital of Heraklion, PO Box 1352, 71110 Heraklion, Crete, Greece. ktjohn@her.forthnet.gr

Telephone: +30-2810-392253

Fax: +30-2810-542085

Received: February 1, 2009
Revised: March 25, 2009
Accepted: April 1, 2009
Published online: June 14, 2009

Abstract

The diagnosis of inflammatory bowel disease (IBD) depends on direct endoscopic visualization of the colonic and ileal mucosa and the histological study of the obtained samples. Radiological and scintigraphic methods are mainly used as an adjunct to endoscopy. In this review, we focus on the diagnostic potential of nuclear medicine procedures. The value of all radiotracers is described with special reference to those with greater experience and more satisfactory results. Tc-99m hexamethylpropylene amine oxime white blood cells remain a widely acceptable scintigraphic method for the diagnosis of IBD, as well as for the evaluation of disease extension and severity. Recently, pentavalent Tc-99m dimercaptosuccinic acid has been recommended as an accurate variant and a complementary technique to endoscopy for the follow-up and assessment of disease activity. Positron emission tomography alone or with computed tomography using fluorine-18 fluorodeoxyglucose appears to be a promising method of measuring inflammation in IBD patients.

Keywords: Crohn’s disease, Technetium-99m pentavalent dimercaptosuccinic acid, Intestinal inflammation, Scintigraphy, Ulcerative colitis