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Journal: گوارش
Year:2015 | Volume: | Issue:
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Title

EVALUATION OF ACCURACY OF 99MTC (V)-DIMERCAPTOSUCCINIC ACID SCINTIGRAPHY AND FECAL CALPROTECTIN VERSUS COLONOSCOPY IN LOCALIZING ACTIVE LESION IN INFLAMMATORY BOWEL DISEASE

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Abstract

 Introduction: Since inflammatory bowel disease (IBD) requires long-term monitoring due to the chronic nature of the disease and the endoscopy is not tolerated well by patients, other methods including fecal calprotectin level and scintigraphy have been developed to monitor the activity and severity of the disorder. In current study, we aimed to prospectively compare the sensitivity, specificity and accuracy of 99mTc (V) DMSA and fecal calprotectin with ileocolonoscopy as novel methods for localizing inflammations.Methods: Current prospective study was conducted between2012 and 2014on 30 IBD patients (21female and9males; age range: 18-65 years) attending gastroenterology clinic of Tehran University of Medical Sciences. The female patients who were pregnant and lactating were excluded from the study. The disease activity was assessed by means of Crohn’s disease Activity Index (CDAI) and Mayo score for all participants.The fecal calprotectin level was also measured for all cases. After the primary evaluations, all patients underwent 99mTc (V) DMSA scintigraphy and colonoscopy. The accuracy of 99mTc (V) -DMSA scintigraphy and calprotectin in localizing bowel lesions were calculated. All statistical analysis were performed using SPSS statistical software (Pvalue< 0.05).Results: A total of 22 ulcerative colitis (UC) and 8Crohn’s disease (CD) cases were evaluated in our study with mean disease duration of 7.27± 7.17 (1-23) and 7.62± 8.79 (1-23) years for UC and CD patients, respectively. The sensitivity, positive likelihood ratio (PLR), positive predictive value (PPV) of scintigraphy and calprotectin over colonoscopy in localizing theUC lesions were 86.36%, 0.86%, 100.00% and 90.91%, 0.91, 100.00%, respectively.Meanwhile, the sensitivity, specificity, PLR, negative likelihood ratio (NLR), PPV and negative predictive value (NPV) for scintigraphy and calprotectin over colonoscopy were reported to 66.67%, 81.25%, 3.56, 0.41, 84.21% of 61.90%, respectively in localizing lesions in CD patients. Even though, the calprotectin level had sensitivity, PLR and PPV of 90.00%, 0.90, and 100.00% in detecting active disease over colonoscopy, respectively.Conclusion: Considering results of our study, the 99mTc (V) DMSA scintigraphy would be an accurate method for detecting active inflammation in IBD patients and is a better choice for the follow up and assessing the disease activity, response to treatment and progression of disease.

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