The role of 99mTc (V)Dimercapto-succinic acid in the evaluation of patients with inflammatory bowel disease

Purpose: Several scintigraphic methods have been used for the evaluation of intestinal inflammation (radiolabelled leucocytes, monoclonal antibodies ecc). Radiolabelled leucocytes seem to be the most sensitive and specific method in the evaluation of patients with inflammation bowel disease (IBD) but because of their disadvantages (high cost, problems in availability, problems in the labeling procedures) their use is limited. The role of 99mTc (V) DMSA in the diagnosis of bone and joint infection has been recognized. The purpose of this study was to evaluate the role of this procedure in the identification of patients with active disease. Materials and Method: From November 2001 through January 2002, 45 patients with known IBD were entered in this prospective study. In 32/45 the diagnosis was N. Crohn and in 13 /45 ulcerative colitis. 18 /45 were in inactive phase and the rest in active disease. All of them underwent examinations including 99mTc (V) DMSA scintigraphy. Twenty five mCi of the radiotracer were injected intravenously and planar anterior images of the abdomen with the patient in supine position, were obtained with a γ camera GE Millennium equipped with a low energy general purpose (LEGP) collimator, 2-4 hours p.i. The bowel was divided in 5 segments: small bowel, ascending colon, transverse colon, descending colon, rectosigmoid. The uptake of the radiotracer was graded relative to uptake in the iliac crest bone marrow as score 0,1,2,3. Results: True positive: 25/27; True negative: 10/18; False positive: 2/27; False negative: 8/18. Conclusion: Despite the small number of our patients the 99mTc (V) DMSA scintigraphy seems to be very sensitive in the detection and evaluation of the inflammation bowel activity