Abstracts
1999 Digestive Disease Week

# 2180 A NEW 99M-TC-LABELLED ANTI-WBC ANTIBODY (LEUTECH) FOR DIAGNOSING ACUTE APPENDICITIS WITH EQUIVOCAL PRESENTATION.
Eric B. Rypins, Samuel L. Kipper, Tri City Med Ctr, Oceanside, CA

We tested a Tc-labeled anti-WBC antibody (LeuTech) for diagnosing equivocal appendicitis. LeuTech labels WBC's in vivo, avoiding blood withdrawal, WBC separation and reinjection. 49 patients with RLQ pain and equivocal history, physical exam or lab tests were evaluated by surgeons and deemed to have an equivocal presentation. The surgeon specified treatment plan prior to WBC scan. Choices were discharge from ER, admit for observation, or operate immediately. The pre scan plan was compared with actual management after receiving scan results. Result: Management plans were changed in 66%. Scan sensitivity = 100%, specificity = 87%, accuracy = 93%, positive predictive value = 86%, negative predictive value = 100%. Mean time to 1st positive image = 36 min., positive diagnosis = 1.2 hr. Conclusions: LeuTech changed patient management and reduced the risks of managing equivocal appendicitis by eliminating admission and observation (38->5 patients), avoiding discharging 2 patients with appendicitis and operating on 1 without it.

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