Proceedings of The British Institute of Radiology, Nuclear medicine in gastroenterology, 14 February 1989

Abstract

It has been been suggested (Anderson et al, 1983) that 111In autologous white blood cell (WBC) imaging may be an accurate prognostic factor in predicting the severity of an attack of acute pancreatitis. We have compared 111In WBC imaging 24 h after injection with ultrasound and with the modified Glasgow biochemical prognostic criteria (Leese et al, 1988) in 24 patients. 111In imaging was performed at a median time of 6 days from diagnosis of pancreatitis (range 1–14 days) and ultrasonography was performed at a median time of 4 days (range 1–15 days). Biochemical prognostic factors were established within 12 h of admission. Of the three actual clinically severe cases, two had abnormal pancreatic uptake of 111Inlabelled leukocytes, two had abnormal ultrasound scans and one was predicted by prognostic factors.There were 21 clinically mild cases. 111In imaging was equivocally positive in one patient and positive in eight others, with a false positive rate of 9/21. Ultrasound was not performed in one patient and did not visualize the pancreas in five. The remaining 15 ultrasound scans were normal. Prognostic criteria predicted all the mild cases. In conclusion, 111In imaging may have a useful role in the detection of severe acute pancreatitis, although in this preliminary study we have found a relatively low specificity (57%) compared with previous reports (Anderson et al, 1983).