CLINICAL-SIGNIFICANCE AND PROGNOSTIC VALUE OF IN-111 LABELED LEUKOCYTE SCANNING IN CROHNS-DISEASE - A PROSPECTIVE-STUDY

The role of 111-Indium leucocyte scanning in assessing the clinical activity of Crohn's disease is still unclear. Thirty-four patients with Crohn's disease - eight with active disease [Crohn's disease activity index (CADI) > 150] - were prospectively studied with standard 111-In-labelled mixed leucocyte scans. Location of the lesions, their extent (measured as lesion-occupied cells on the scanned area), the degree of inflammatory activity (assessed as count ratio between region of interest and iliac crest) and scintigraphic score, were calculated. When multiple lesions were detected, the sum of the parameters of each region was calculated. Analysis of interobserver agreement on location of the lesions showed that the discrepancies were more frequent when uptake in the lesions was low. Notwithstanding these discrepancies, both observers assessed each patient for total count ratios, extent of lesions and scintigraphic score which were well related to clinical and laboratory activity of the disease. Twenty out of 26 patients in clinical remission had positive scans. In five patients who later relapsed, the total count ratio from the 4th to the 24th hour did not change significantly, compared with a decrease in the total count ratio from early to delayed scans in patients who remained in remission. 111-In-labelled leucocyte scan offers some clinical and prognostic information about Crohn's disease.