October 1989

Improving Diagnosis of AppendicitisEarly Autologous Leukocyte Scanning

Author Affiliations

From the Departments of Surgery (Drs DeLaney, Raviola, and McDonald) and Nuclear Medicine (Drs Weber and Navarro and Mr Jasko), Kaiser Permanente Medical Center, Oakland, Calif. Dr DeLaney is now with the Division of Plastic Surgery, St Francis Hospital, San Francisco, Calif, and Dr Raviola is now with the Department of Surgery, University of Pennsylvania, Philadelphia.

Arch Surg. 1989;124(10):1146-1152. doi:10.1001/archsurg.1989.01410100044009

• A prospective nonrandomized study investigating the accuracy and utility of autologous leukocyte scanning in the diagnosis of apendicitis was performed. One hundred patients in whom the clinical diagnosis of appendicitis was uncertain underwent indium 111 oxyquinoline labeling of autologous leukocytes and underwent scanning 2 hours following reinjection. Of 32 patients with proved appendicitis, three scans revealed normal results (false-negative rate, 0.09). Of 68 patients without appendicitis, three scans had positive results (false-positive rate, 0.03; sensitivity, 0.91; specificity, 0.97; predictive value of positive scan, 0.94; predictive value of negative scan, 0.96; and overall accuracy, 0.95). Scan results altered clinical decisions in 19 patients. In 13 cases, the scan produced images consistent with diagnoses other than appendicitis, expediting appropriate management. Early-imaging111 In oxyquinoline autologous leukocyte scanning is a practical and highly accurate adjunct for diagnosing appendicitis.

(Arch Surg. 1989;124:1146-1152)