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. 2011 Aug;20(2):45-51.
doi: 10.4274/MIRT.24. Epub 2011 Aug 1.

The Agreement Between Blood Pool - Delayed Bone Scintigraphy and Tc-99m Human Immunoglobulin G (HIG) Scintigraphy in the Determination of the Presence and Severity of Inflammatory Arthritis

Gulizar Kacar  1 , Cahit Kacar, Firat Gungor
Affiliations

The Agreement Between Blood Pool - Delayed Bone Scintigraphy and Tc-99m Human Immunoglobulin G (HIG) Scintigraphy in the Determination of the Presence and Severity of Inflammatory Arthritis

Gulizar Kacar et al. Mol Imaging Radionucl Ther. 2011 Aug.

Abstract

Objective: In this study, it was aimed to investigate the agreement between early phase of bone scintigraphy - human immunoglobulin scintigraphy (EPBS-HIG) and late phase bone scintigraphy - HIG (LPBS-HIG) in the determination of the presence and also the severity of inflammatory arthritis.

Material and methods: Twenty-eight patients (23 female, 5 male; between 19 to 80 years of age) with inflammatory arthritis were included in the study. Tc-99m HIG and blood pool/late phase bone scintigraphies were performed in all patients. In scintigraphic examinations, the joints were scored with the degree of accumulation of the radiopharmaceutical by the semiquantitative analysis (0=Background activity, 1=Faint uptake, 2=Moderate uptake, 3=Marked uptake) which is called as visually active joint score as severity index of the disease. To estimate the agreement between EPBS - HIG and LPBS - HIG in the determination of the presence and severity of inflammatory arthritis, 2x2 kappa coefficients were calculated.

Results: Our results showed good agreement between EPBS - HIG for the presence of inflammation (kappa: 0.72) but not for the severity of the disease (kappa: 0.29), poor agreement between LPBS - HIG for both the presence (kappa: 0.51) and severity (kappa: 0.01) of inflammatory arthritis.

Conclusion: The blood pool scintigraphy could be used in the investigation of the presence of inflammatory arthritis because the good agreement with HIG and the lower cost but not for the severity of the disease Conflict of interest:None declared.

Keywords: Reactive Arthritis; Rheumatoid Arthritis; Technetium 99m HIG.

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Figures

Figure 1
Figure 1. Tc 99m HIG scintigraphy (A) and Tc 99m Medronate bloodpool scintigraphy (B) in the same patientFaint uptake (VAJS= 1) in the proximal interphalangeal joint (at 3rd phalanx of theright hand) and normal uptake of radiopharmaceutical at the level of backgroundactivity (VAJS=0) for other joints of both hands and wrists in HIG and Medronateblood pool scintigraphy
Figure 2
Figure 2. Tc 99m HIG scintigraphy (A) and Tc 99m Medronate bloodpool scintigraphy (B) in the same patientModerate uptake (VAJS=2) in both wrists and metacarpophalangeal joints. Faintand moderate uptake in proximal interphalangeal joints by HIG and Medronateblood pool scintigraphy
Figure 3
Figure 3. Tc 99m HIG scintigraphy (A) and Tc 99m Medronate bloodpool scintigraphy (B) in the same patientMarked uptake (VAJS=3) in both wrists. Normal uptake in other joints of bothhands by HIG and Medronate blood pool scintigraphy
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