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Part of the book series: Developments in Nuclear Medicine ((DNUM,volume 31))

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Abstract

Inflammatory bowel disease (IBD) is a chronic condition with a relapsing course which often begins at an early age and affects the patient for life. It involves the bowel to a variable extent. In ulcerative colitis (UC) it is limited to the colon whereas in Crohn’s disease it can affect any part of the bowel, in a discontinuous fashion. Management depends on knowledge of the type, site, extent and activity of inflammation and in Crohn’s disease, other aspects of the disease contributing to severity such as fistulation, abscesses and malabsorption [1]. Because of the need for repeated investigation of the patient, the least invasive approach is desirable. Such approaches will be discussed in this chapter in addition to investigation of suspected complicating intra-abdominal sepsis.

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References

  1. Goldberg HI, Brooke JR. Recent advances in the Radiographic Evaluation of Inflammatory Bowel Disease. Med Clin North Am 1980;64:1059–1081.

    PubMed  CAS  Google Scholar 

  2. Watts JMK, de Dombal FT, Goligher JC. Early results of surgery for ulcerative colitis. Br J Surg 1966;53:1005–1014.

    Article  PubMed  CAS  Google Scholar 

  3. Metchnikoff E. Immunity in infective diseases. Cambridge: Cambridge University Press, 1905: 175–206.

    Google Scholar 

  4. Dancey J, Deubelbeiss K, Harker L, Finch C. Neutrophil kinetics in man. J Clin Invest 1976;58:705–715.

    Article  PubMed  CAS  Google Scholar 

  5. Lavender JP, Lowe J, Barker JR, Burn JI, Chaudhri MA. Gallium-67 citrate scanning in neoplastic and inflammatory lesions. Br J Radiol 1971; 44:361–366.

    Article  PubMed  CAS  Google Scholar 

  6. Mc Afee J, Thakur M. Survey of radioactive agents for in vitro labelling of phagocytic leucocytes. 1. Soluble agents. J Nucl Med 1976; 17:480–487.

    CAS  Google Scholar 

  7. Keshavarzian A, Price YE, Peters AM, Lavender JP, Wright NA, Hodgson HJ. Specificity of indium-111 granulocyte scanning and faecal excretion measurement in inflammatory bowel disease-an autoradiographic study. Digest Dis Sci 1985;30:1156–1160.

    Article  PubMed  CAS  Google Scholar 

  8. Zakhireh B, Thakur ML, Malech HL, Cohen MS, Gottschalk A, Root RK. Indium-111-labelled human polymorphonuclear leukocytes: viability, random migration, chemotaxis, bactericidal capacity and ultrastructure. J N Med 1979;20:741–747.

    CAS  Google Scholar 

  9. Saverymuttu S, Camilleri M, Rees H, Lavender J, Hodgson H, Chadwick V. Indium 111-granulocyte scanning in the assessment of disease extent and disease activity in inflammatory bowel disease. A comparison with colonoscopy, histology, and faecal indium 111-granulocyte excretion. Gastroenterology 1986;90:1121–1128.

    PubMed  CAS  Google Scholar 

  10. Peters AM, Danpure HJ, Osman S, Hawker RJ, Henderson BL, Hodgson HJ, Kelly JD, Neirinckx RD, Lavender JP. Clinical experience with 99mTc-hexamethyl-propyleneamineoxime for labelling leucocytes and imaging inflammation. Lancet 1986;2:946–949.

    Article  PubMed  CAS  Google Scholar 

  11. Neirinckx RD, Canning LR, Piper IM, et al. Tc-99m d,l-HM-PAO: A new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion. J Nucl Med 1987;28:191–202.

    PubMed  CAS  Google Scholar 

  12. Scholmerich J, Schmidt E, Schumichen C, Billmann P, Schmidt H, Gerok W. Scintigraphic assessment of bowel involvement and disease activity in Crohn’s disease using technetium 99m-hexamethyl propylene amine oxine as leukocyte label. Gastroenterology 1988;95:1287–1293.

    PubMed  CAS  Google Scholar 

  13. Becker W, Schomann E, Fischbach W, Borner W, Grüner KR. Comparison of 99Tcm-HM-PAO and 111 In-oxine labelled granulocytes in man: first clinical results. Nucl Med Commun 1988;9:435–447.

    Article  PubMed  CAS  Google Scholar 

  14. Shrimpton P, Wall B, Jones D, Fisher E, Hillier M, Kendall G, Harrison R. A national survey of doses to patients undergoing a selection of routine X-ray examinations in English hospitals. National Radiation Protection Board, 1986.

    Google Scholar 

  15. Peters AM, Roddie ME, Danpure HJ, Osman S, Zacharopoulos GP, George P, Stuttle AW, Lavender JP. 99Tcm-HM-PAO labelled leucocytes: comparison with 111 In-tropolonate labelled granulocytes. Nucl Med Commun 1988;9:449–463.

    Article  PubMed  CAS  Google Scholar 

  16. Weldon M. 99mTc-HM-PAO Planar White Cell Scanning. Scand J Gastroenterol 1994;29:36–42.

    Article  Google Scholar 

  17. Modigliani R, Mary J Y, Simon J F, et al. Clinical, biological and endoscopie picture of attacks of Crohn’s disease; evolution on prednisolone. Gastroenterology 1990;98:811–818.

    Article  PubMed  CAS  Google Scholar 

  18. Gibson P, Lichtenstein M, Salehi N, Hebbard G, Andrews J. Value of positive technetium-99m leucocyte scans in predicting intestinal inflammation. Gut 1991;32:1502–1507.

    Article  PubMed  CAS  Google Scholar 

  19. Lantto EH, Lantto TJ, Vorne M. Fast diagnosis of abdominal infections and inflammations with technetium-99m-HMPAO labeled leukocytes. J Nucl Med 1991;32:2029–2034.

    PubMed  CAS  Google Scholar 

  20. Papos M, Nagy F, Lang J, Csernay L. Technetium-99m hexamethyl-propylene amine oxime labelled leucocyte scintigraphy in ulcerative colitis and Crohn’s disease. Eur J Nucl Med 1993;20:766–769.

    Article  PubMed  CAS  Google Scholar 

  21. Vilien M, Nielsen SL, Jorgensen M, Binder V, Hvid JK, Berild D, Kelbaek H. Leucocyte scintigraphy to localize inflammatory activity in ulcerative colitis and Crohn’s disease. Scand J Gastroenterol 1992; 27:582–586.

    Article  PubMed  CAS  Google Scholar 

  22. Sciarretta G, Furno A, Mazzoni M, Basile C, Malaguti P. Technetium-99m hexamethyl propylene amine oxime granulocyte scintigraphy in Crohn’s disease: diagnostic and clinical relevance. Gut 1993;34:1364–1369.

    Article  PubMed  CAS  Google Scholar 

  23. Peters A. Imaging inflammation: current role of labelled autologous leukocytes [editorial]. J Nucl Med 1992;33:65–67.

    PubMed  CAS  Google Scholar 

  24. Saverymuttu SH, Maltby P, Batman P, Joseph AE, Maxwell D. False positive localisation of indium-111 granulocytes in colonic carcinoma. Br J Radiol 1986;59:773–777.

    Article  PubMed  CAS  Google Scholar 

  25. Becker W, Fischbach W, Weppler M, Mosl B, Jacoby G, Borner W. Radiolabelled granulocytes in inflammatory bowel disease: diagnostic possibilities and clinical indications. Nucl Med Commun 1988;9:693–701.

    Article  PubMed  CAS  Google Scholar 

  26. Saptogino A, Becker W, Wolf F. 99mTc-labelled polyclonal human immunoglobulin for localisation of inflammatory sites-early in vitro-results. Nucl Med 1990;29:54–58.

    CAS  Google Scholar 

  27. Hebbard GS, Salehi N, Gibson PR, Lichtenstein M, Andrews JT. 99Tcm-labelled IgG scanning does not predict the distribution of intestinal inflammation in patients with inflammatory bowel disease. Nucl Med Commun 1992; 13:336–341.

    Article  PubMed  CAS  Google Scholar 

  28. Joseph K, Hoffken H, Bosslet K, Schorlemmer HU. Imaging of inflammation with granulocytes labelled in vivo. Nucl Med Commun 1988;9:763–769.

    Article  PubMed  CAS  Google Scholar 

  29. Locher JT, Seybold K. White blood cell scintigraphy. Problems related to the use of monoclonal antibodies. Prog Clin Biol Res 1990;355:327–336.

    PubMed  CAS  Google Scholar 

  30. Boyd SJ, Nour R, Quinn RJ, McKay E, Butler SP. Evaluation of white cell scintigraphy using indium-111 and technetium-99m labelled leucocytes. Eur J Nucl Med 1993;20:201–206.

    Article  PubMed  CAS  Google Scholar 

  31. Peters A, Lavender J, Danpure H, Osman S, Saverymuttu S. Tc-99m autologous phagocyte labelling: a new imaging technique for inflammatory bowel. Br Med J 1986;293:450–451.

    Article  CAS  Google Scholar 

  32. Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol 1989;24:2–6.

    Article  Google Scholar 

  33. Clamp SE, Myren J, Bouchier IAD, Watkinson G, De Dombal FT. Diagnosis of inflammatory bowel disease: an international multicentre scoring system. Br Med J 1982;284:91–95.

    Article  CAS  Google Scholar 

  34. Pera A, Bellando P, Caldera D, et al. Colonoscopy in inflammatory bowel disease.Diagnostic accuracy and proposal of an endoscopic score. Gastroenterology 1987;92:181–185.

    PubMed  CAS  Google Scholar 

  35. Best W, Becktel J, Singleton J, Kern F. Development of a Crohn’s disease activity index. National Co-operative Crohn’s disease study. Gastroenterology 1976;70:439–444.

    PubMed  CAS  Google Scholar 

  36. Hodgson HJF. Assessment of drug therapy in inflammatory bowel disease. Br J Clin Pharmacol 1982; 14:159–170.

    Article  PubMed  CAS  Google Scholar 

  37. Camilleri M, Proano M. Advances in the assessment of disease activity in inflammatory bowel disease. [Review]. Mayo Clinic Proc 1989;64:800–807.

    CAS  Google Scholar 

  38. Bartholomeusz FD, Shearman DJ. Measurement of activity in Crohn’s disease. [Review]. J Gastroenterol Hepatol 1989;4:81–94.

    Article  PubMed  CAS  Google Scholar 

  39. Hanauer SB. Guidelines for the clinical evaluation of drugs for patients with inflammatory bowel disease. Fed Register 1991;56:519.

    Google Scholar 

  40. Modigliani R, Mary Y-J. Groupe d’etudes therapeutiques des affections inflammatoires digestives. Clinical, biological and endoscopic picture of attacks of Crohn’s disease. Evolution on prednisolone. Gastroenterology 1990;98:811–818.

    Article  PubMed  CAS  Google Scholar 

  41. Jenkins D, Goodall A, Drew K, et al. What is colitis? Statistical approach to distinguishing clinically important change on rectal biopsy specimens. J Clin Pathol 1988;41:72–79.

    Article  PubMed  CAS  Google Scholar 

  42. Saverymuttu SH, Peters AM, Crofton ME, Rees H, Lavender JP, Hodgson HJ, Chadwick VS. 111 Indium autologous granulocytes in the detection of inflammatory bowel disease. Gut 1985;26:955–960.

    Article  PubMed  CAS  Google Scholar 

  43. Carpani de Kaski M, Peters AM, Knight D, Stuttle AW, Lavender JP, Hodgson HJ. Indium-111 whole-body retention: a method for quantification of disease activity in inflammatory bowel disease. J Nucl Med 1992;33:756–762.

    Google Scholar 

  44. Spinelli F, Milella M, Sara R, et al. The 99mTc-HMPAO leukocyte scan: an alternative to radiology and endoscopy in evaluating the extent and the activity of inflammatory bowel disease. J Nucl Biol Med 1991;35:82–87.

    PubMed  CAS  Google Scholar 

  45. Giaffer MH, Tindale WB, Senior S, Barber DC, Holdsworth CD. Quantification of disease activity in Crohn’s disease by computer analysis of Tc-99m hexamethyl propylene amine oxime (HMPAO) labelled leucocyte images. Gut 1993;34:68–74.

    Article  PubMed  CAS  Google Scholar 

  46. Stein P, Gray G, Gregory P, Anderson M, Goodwin D, McDougall I. Location and activity of ulcerative and Crohn’s colitis by indium-Ill leukocyte scan. Gastroenterology. 1983;84:388–393.

    PubMed  CAS  Google Scholar 

  47. De Nardo G, Macey D, DeNardo S, Zhang C, Custer T. Quantitative SPECT of uptake of monoclonal antibodies. Sem Nucl Med 1989; 19:22–32.

    Article  Google Scholar 

  48. Weldon MJ, Masoomi AM, Britten AJ, Gane J, Finlayson CJ, Joseph A, Maxwell JD. Quantification of inflammatory bowel disease using technetium-99m-HMPAO labelled leucocyte Single Photon Emission Computerised Tomography (SPECT). Gut 1995;36:243–250.

    Article  PubMed  CAS  Google Scholar 

  49. Truelove S, Witts L. Cortisone in ulcerative colitis: final report on a therapeutic trial. Br Med J 1955;1041–1044.

    Google Scholar 

  50. Lantto E, Jarvi K, Krekela I, et al. Technetium-99m hexamethyl propylene amine oxine leucocytes in the assessment of disease activity in inflammatory bowel disease. Eur J Nucl Med 1992; 19:14–18.

    Article  PubMed  CAS  Google Scholar 

  51. Aimer S, Franzen L, Peters AM, et al. Do technetium-99m hexamethylpropylene amine oxime-labeled leukocytes truly reflect the mucosal inflammation in patients with ulcerative colitis? Scand J Gastroenterol 1992;27:1031–1038.

    Article  Google Scholar 

  52. Rosenbusch G, Jansen JB, Reeders JW. Contemporary radiological examination of the small bowel. In: Tytgat GNJ, Reeders JWAJ ed. Diagnostic imaging of the gastrointestinal tract: part 1. London: Bailliere Tindall, 1994: 683–700.

    Google Scholar 

  53. Saverymuttu SH, Peters M, Hodgson JH, Chadwick VS, Lavender JP. 111 Indium leukocyte scanning in small bowel Crohn’s disease. Gastrointest Radiol 1983;8:157–161.

    Article  PubMed  CAS  Google Scholar 

  54. Park RH, McKillop JH, Duncan A, MacKenzie JF, Russell RI. Can 111 indium autologous mixed leucocyte scanning accurately assess disease extent and activity in Crohn’s disease? Gut 1988;29:821–825.

    Article  PubMed  CAS  Google Scholar 

  55. Crama BG, Arndt JW, Pena AS, et al. Value of indium-111 granulocyte scintigraphy in the assessment of Crohn’s disease of the small intestine: prospective investigation. Digestion 1988;40:227–236.

    Article  Google Scholar 

  56. Froelich JW, Field SA. The role of Indium-111 white blood cells in inflammatory bowel disease. Sem Nucl Med 1988; 18:300–307.

    Article  CAS  Google Scholar 

  57. Kennan N, Hayward M. Tc HMPAO-labelled white cell scintigraphy in Crohn’s disease of the small bowel. Clin Radiol 1992;45:331–334.

    Article  PubMed  CAS  Google Scholar 

  58. Fry DE, Garrison RN, Heitsch RC, Calhoun K, Polk JHC. Determinants of death in patients with intraabdominal abscess. Surgery 1980;88:517–523.

    PubMed  CAS  Google Scholar 

  59. Saverymuttu S, Peters A, Lavender J. Clinical importance of enteric communication with abdominal abscesses. Br Med J 1985;290:23–26.

    Article  CAS  Google Scholar 

  60. Joseph AE. Imaging of abdominal abscesses [editorial]. Br Med J Clin Res 1985;291:1446–1447.

    Article  CAS  Google Scholar 

  61. Doust BD, Quiroz F, Stewart JM. Ultrasonic distinction of abscesses from other intra abdominal fluid collections. Ultrasound 1977; 125:213–217.

    CAS  Google Scholar 

  62. Knöchel JQ, Koehler PR, Lee TG, Welch DM. Diagnosis of abdominal abscesses with computed tomography, ultrasound, and 111 In leukocyte scans. Radiology 1980; 137:425–432.

    PubMed  Google Scholar 

  63. Thakur ML, Coleman RE, Mayhall CG, Welch MJ. Preparation and evaluation of 111 In labelled leukocytes as an abscess imaging agent in dogs. Radiology 1976; 119:731–732.

    PubMed  CAS  Google Scholar 

  64. Segal A, Thakur M, Arnot R, Lavender J. 111 Indium labelled leucocytes for localisation of abscesses. Lancet 1976; 13:1056–1058.

    Article  Google Scholar 

  65. Coleman RE, Black RE, Welch DM, Maxwell JG. Indium-111 labeled leukocytes in the evaluation of suspected abdominal abscesses. Am J Surg 1980; 139:99–104.

    Article  PubMed  CAS  Google Scholar 

  66. Goldman M, Ambrose NS, Drolc Z, Hawker RJ, McCollum C. Indium-111-labelled leucocytes in the diagnosis of abdominal abscess. Br J Surg 1987;74:184–186.

    Article  PubMed  CAS  Google Scholar 

  67. Baldwin JE, Wraight EP. Indium labelled leucocyte scintigraphy in occult infection: a comparison with ultrasound and computed tomography. Clin Radiol 1990;42:199–202.

    Article  PubMed  CAS  Google Scholar 

  68. Steinberg DM, Cooke WT, Alexander-Williams J. Abscess and fistulae in Crohn’s disease. Gut 1973;14:865–869.

    Article  PubMed  CAS  Google Scholar 

  69. Lantto EH. Leucocytes labelled with 99mTc-HMPAO in the detection of abdominal abscesses. Eur J Surg 1991; 157: 469–472.

    PubMed  CAS  Google Scholar 

  70. Mountford P, Kettle A, O’Doherty M, Coakley A. Comparison of Technetium-99m-HM-PAO leukocytes with indium 111-oxime leukocytes for localising intra abdominal sepsis. J Nucl Med 1989; 31: 311–315.

    Google Scholar 

  71. Datz LF, Luers P, Baker WJ, Christian PE. Improved detection of upper abdominal abscesses by combination of 99mTc sulfur colloid and 111 Indium leukocyte scanning. Am J Radiol 1985; 144: 319–323.

    CAS  Google Scholar 

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Weldon, M.J. (1998). Inflammatory Bowel Disease. In: Cox, P.H., Buscombe, J.R. (eds) The Imaging of Infection and Inflammation. Developments in Nuclear Medicine, vol 31. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4990-7_8

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  • DOI: https://doi.org/10.1007/978-94-011-4990-7_8

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