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By Amos; Talmi, Igal; (deshalit) de-Shalit
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99mTc-HMPAO-WBC are obtained when WBC in vitro tests are used; values range from 80 % to 100 % (Martin-Comin and Prats 1999). Figures are slightly lower for radiolabelled antigranulocyte monoclonal antibodies. Among the commercially available agents, human immunoglobulins that can be labelled with indium or with technetium are not indicated for the diagnosis of IBD. 2 illustrate the differences between patients with and without IBD. In the case of Fig. 1, a patient with ulcerative colitis (UC), the distribution of the activity in the lesion follows the bowel configuration, while in Fig.
The answer, in my opinion, is yes, the test can be performed in children. The radiation burden is acceptable and different papers have been published in this context. Especially interesting is the work from Tobling and co-workers (1996), where they have studied 31 children and they have compared WBC scan, contrast radiology and endoscopy versus histology. 5 % and endoscopy was 87 % when compared with histological results. The group from the Hospital Clinic in Zaragoza (Prats et al. 2000) studied 46 children ranging from 8 to 18 years.
The WBC scan cannot be used as a screening method, but is indicated in patients in whom the suspicion or the prevalence of the disease is expected to be high or medium. WBC scanning is also useful to discard other pathologies, because of its high sensitivity, and to evaluate disease extension. It is also useful to have a scan at the beginning of the disease to use it as reference exam. In the follow-up, the test is able to differentiate between fibrosis and active disease, to diagnose complications as fistulae and others, and to evaluate the efficacy of treatment.