Determining the proximal extent of ulcerative colitis: white cell scan correlates well with histological assessment
- 22 January 2007
- journal article
- Published by Wiley in Alimentary Pharmacology & Therapeutics
- Vol. 25 (4), 441-446
- https://doi.org/10.1111/j.1365-2036.2006.03222.x
Abstract
Assessing the extent of ulcerative colitis determines therapeutic strategies and provides prognostic information. Colonoscopy with mucosal biopsy is considered unsafe in patients with severe disease. To assess the correlation between proximal extent of ulcerative colitis as determined by Technitium-99-m hexamethylpropylene amine oxime labelled leucocyte scan (white cell scan) with that determined by histological assessment. One hundred and thirty-five patients, with histologically-confirmed ulcerative colitis, who had a white cell scan and histological assessment of colonic inflammation within 6 months of each other, during the years 1991-2004, were included. Overall agreement, quadratic-weighted kappa (kappa) and polychoric correlations (rho) were calculated to estimate the inter-rater reliability. The correlation between white cell scan and histological extent was excellent (kappa = 0.7 rho = 0.8). Macroscopic appearance on colonoscopy did not correlate as well with histological extent (kappa = 0.62 and rho = 0.67). White cell scans correlated significantly better in patients with extensive disease (P = 0.02). Colonoscopy predicted disease extent more accurately in patients with limited colitis (P = 0.002). Proximal extent of ulcerative colitis determined by white cell scans correlates well with histological assessment especially in patients with more extensive disease. White cell scans offer a reasonable alternative to colonoscopy with mucosal biopsies in determining the proximal extent of colitis.Keywords
This publication has 24 references indexed in Scilit:
- Risk of colorectal cancer in ulcerative colitis in IndiaJournal of Gastroenterology and Hepatology, 2005
- Guidelines for the management of inflammatory bowel disease in adultsGut, 2004
- The Clinical Significance of Right-sided Colonic Inflammation in Patients with Left-sided Chronic Ulcerative ColitisInflammatory Bowel Diseases, 2004
- Plain abdominal radiographic features are not reliable markers of disease extent in active ulcerative colitisThe American Journal of Gastroenterology, 2002
- Clinical Course during the 1st Year after Diagnosis in Ulcerative Colitis and Crohn's Disease: Results of a Large, Prospective Population-based Study in Southeastern Norway, 1990-93Scandinavian Journal of Gastroenterology, 1997
- Instant technetium 99m hexamethyl propylenamine oxime-labeled leukocyte scan compared with colonoscopy in early assessment of disease extent and activity in acute colitisDiseases of the Colon & Rectum, 1996
- Validation of 99Tcm-HMPAO leucocyte scintigraphy in ulcerative colitis by comparison with histologyThe British Journal of Radiology, 1995
- Do Technetium-99m Hexamethylpropylene Amine Oxime-Labeled Leukocytes Truly Reflect the Mucosal Inflammation in Patients with Ulcerative Colitis?Scandinavian Journal of Gastroenterology, 1992
- COLONOSCOPIC DIAGNOSIS OF MINIMAL CHANGE COLITIS IN PATIENTS WITH A NORMAL SIGMOIDOSCOPY AND NORMAL AIR-CONTRAST BARIUM ENEMAThe Lancet, 1982
- TOXIC DILATATION OF COLON (TOXIC MEGACOLON)Medicine, 1969