Radio localization of inflammatory bowel diseases using 99mtc-colloidal bismuth subcitrate

A correct diagnosis and adequate assessment of disease activity is crucial in the management and surveillance of inflammatory bowel diseases (IBDs). However, in certain occasions the obtained results by means of traditional techniques are not correlated specifically with the inflammatory state of the mucosal wall, mainly in case of the small bowel, due to its no accessibility. This investigation constituted a multi centric clinical trial phase I-II. Forty-four patients were prospectively evaluated with the objective of determining the validity of the scintigraphy with 99mTc-Sn-CBS for the diagnosis of illnesses with ulcerations of the intestinal tube. Of the evaluated patients, 20 presented Cohns Disease (in 1 of them the scintigraphy was not useful), Idiopathic Ulcerative Colitis, 3 gastric ulcer and 20 patients were seemingly healthy, conforming these last ones the group control. Five hundred mgs of CBS were labelled with 370 MBq (10 mCi) of 99mTc and administered by oral via as unique dose. The diagnostic test had duration of three days for each patient: first day for the patient's preparation with soft diet and 20% mannitol and two days for the image registrations. The images were carried out at 2, 4, 6 and 24 hours post administered the product. All procedures were performed by experienced examiners, who were blinded to the clinical data and other results. It was determined the sensibility and specificity of this technique taking like reference test, the colonoscopy, gastroduodenoscopy, intestinal transit and/or biopsy, achieving a sensibility of 91,3% and a specificity of 90%. During the whole study an adverse event appeared, which had not very probable causation according to the scale of Karch and Lasagna. It can be concluded that the diagnostic criteria established in this study can be useful for the evaluation of inflammatory bowel diseases by scintigraphy with 99mTc-Sn-CBS. (Author)