Role of molecular imaging in the management of patients affected by inflammatory bowel disease: State-of-the-art

Table 5 Studies on molecular imaging in paediatric patients included in the present review

Ref.	Year	Pts (n)	Age (range)	Type of study	Clinical setting	Principal results	Technique	Segments evaluated (n)	Criterion for positivity
Papós et al[48]	1996	20	4-18	Prospective	IBD	sensitivity, specificity, and accuracy of LS were 93%, 88% and 91%, respectively	99mTc-HMPAO-WBC planar scintigraphy (30 min and 2 and 3 h)		Scored relative to the normal bone marrow uptake (0, no uptake; 1 < bone marrow uptake; 2 = bone marrow uptake; and 3 > bone marrow uptake)
Charron et al[36]	1998	178	n.r.	Retrospective		Useful in distinguishing discontinuous from continuous colitis	99mTc-HMPAO-WBC planar scintigraphy + SPECT (0.5-1 h, 2-4 h)
Cucchiara et al[35]	1999	48	2-17	Prospective	suspected IBD	significant correlation between results of scintigraphy and endoscopy for the intensity of inflammation	99mTc-HMPAO-WBC planar scintigraphy (dynamic + 30, 60, 120 and 180 min)	9	Abnormal if activity was seen in the gut within the first hour. 0 = no labeling; 1 = less than bone marrow; 2 = greater than bone marrow, less than liver; and 3 = greater than or equal to liver
Del Rosario et al[50]	1999	35	2-20	Retrospective	IBD	83% sensitivity which prompted more aggressive management in 75% of cases	99mTc-HMPAO-WBC planar scintigraphy (30 min + 2 h)
Charron et al[33]	1999	184	n.r.	Retrospective		Sensitivity = 90%, specificity = 97%, overall accuracy = 93%	99mTc-HMPAO-WBC planar scintigraphy + SPECT (0.5-1 h, 2-4 h ± 6 h ± 24 h)
Charron et al[37]	2000	262	n.r.	Retrospective	IBD	Useful as initial screening modality to exclude IBD	99mTc-HMPAO-WBC planar scintigraphy + SPECT (0.5-1 h, 2-4 h)
Alberini et al[32]	2001	28	2-15	Retrospective		Sensitivity and specificity were 75% and 92% for 99mTc-HMPAO-WBC	99mTc-HMPAO-WBC planar scintigraphy (1 + 3 h, p.i.)
Davison et al[38]	2001	10	n.r.	Prosepctive	CD	99mTc-HMPAO leucocyte scintigraphy should not be depended upon as a screening test for Crohn’s disease	99mTc-HMPAO-WBC planar scintigraphy + (45 min + 3.5 h)		Abdominal isotope uptake equal to or greater than that associated with the bone marrow was considered to indicate significant inflammation
Bruno et al[41]	2002	66	4-19	Prospective		Sensitivity of immunoscitigraphy was 94% for CD and 85% for UC with a relative low specificity	99mTc-BW250/183 planar scintigraphy (4 + 24 h, p.i.)
Grahnquist et al[39]	2003	95	2-16	Prospective	Suspected IBD (screening test)	As a screening test for children with suspected IBD the calculated sensitivity was 75%, and the specificity was 82%	99mTc-HMPAO-WBC planar scintigraphy (45 min + 3.5 h)	6
Peacock et al[40]	2004	64	2-19	Retrospective	Suspected IBD	99mTc-Stannous colloid LS had an 88% sensitivity, 90% specificity	99mTc-stannous colloid WCS planar + SPECT (1 h, 3 h)
Chroustova et al[47]	2009	40	5-18		Monitoring IBD (17 = UC, 23 = CD)	99mTc-HMPAO-WBC provided good information about the current stage of disease in IBD monitoring	99mTc-HMPAO-WBC planar scintigraphy + SPECT (30-45 min, 2 h, 3 h)		Graded 1-3 according to the uptake intensity. Grade 1 = a barely detectable abnormal uptake, grade 3 = an abnormal uptake at least as intense as that in the bone marrow and grade 2 was between these extremes. The extent of the abnormal uptake was subjectively classified as A (restricted to a single small focus), C (diffuse, such as in pancolitis) or B (between these extremes)
Caobelli et al[34]	2011	52	2-17	Prospective		Sensitivity of 94%, specificity of 86%, and negative predictive value of 96% to diagnose IBD. During the follow-up, all relapses and remissions were correctly recognized	99mTc-HMPAO-WBC planar scintigraphy (0.5 h, 3 h, p.i.)		Disease severity was graded by the focal uptake intensity vs iliac bone uptake (Scan Activity Index) and compared with Endoscopy Mayo Score

SPECT: Single photon emission tomography; CD: Crohn’s disease; UC: Ulcerative colitis; IBD: Inflammatory bowel disease; WBC: White blood cell; LS: Leukocyte scintigraphy; pts: Patients.