AIM: Lower gastrointestinal (GI) hemorrhage is a complex clinical problem that requires disciplined evaluation for successful management. This study was conducted to evaluate the applicability of single photon emission computed tomography/computed tomography (SPECT/CT) in patients with acute lower gastrointestinal bleeding undergoing scintigraphy with 99mTc-labelled red blood cells (RBC), and to assess the additional clinical value of fused images when compared to the standard radionuclide scan. METHODS: Twenty-seven patients presenting with acute lower GI tract hemorrhage were studied with conventional dynamic and planar 99mTc-RBC imaging. In 19 patients with positive findings on scans taken within 6 hours, a SPECT/CT study was immediately performed using a hybrid system composed of a dual-head, variable angle gamma camera and an X-ray tube. The number of patients in whom SPECT/CT changed the scintigraphic interpretation with regard to the presence or site of GI blood loss as confirmed by other diagnostic or therapeutical procedures was recorded. RESULTS: Image fusion was easy and successful in all patients showing perfect correspondence between SPECT and CT data and allowing precise anatomical localization of the sites of 99mTc-RBC extravasation. SPECT/CT had significant impact on the scintigraphic results in 7/19 patients (36.8%): in 6 patients it precisely localized the bleeding foci whose location could not be identified in standard scans and in one it excluded the presence of an active GI hemorrhage. CONCLUSIONS: SPECT/CT with a hybrid system is feasible and useful for facilitating imaging interpretation and improving the accuracy of 99mTc-RBC scintigraphy in patients with acute lower GI bleeding.
AIM: Lower gastrointestinal (GI) hemorrhage is a complex clinical problem that requires disciplined evaluation for successful management. This study was conducted to evaluate the applicability of single photon emission computed tomography/computed tomography (SPECT/CT) in patients with acute lower gastrointestinal bleeding undergoing scintigraphy with 99mTc-labelled red blood cells (RBC), and to assess the additional clinical value of fused images when compared to the standard radionuclide scan. METHODS: Twenty-seven patients presenting with acute lower GI tract hemorrhage were studied with conventional dynamic and planar 99mTc-RBC imaging. In 19 patients with positive findings on scans taken within 6 hours, a SPECT/CT study was immediately performed using a hybrid system composed of a dual-head, variable angle gamma camera and an X-ray tube. The number of patients in whom SPECT/CT changed the scintigraphic interpretation with regard to the presence or site of GI blood loss as confirmed by other diagnostic or therapeutical procedures was recorded. RESULTS: Image fusion was easy and successful in all patients showing perfect correspondence between SPECT and CT data and allowing precise anatomical localization of the sites of 99mTc-RBC extravasation. SPECT/CT had significant impact on the scintigraphic results in 7/19 patients (36.8%): in 6 patients it precisely localized the bleeding foci whose location could not be identified in standard scans and in one it excluded the presence of an active GI hemorrhage. CONCLUSIONS: SPECT/CT with a hybrid system is feasible and useful for facilitating imaging interpretation and improving the accuracy of 99mTc-RBC scintigraphy in patients with acute lower GI bleeding.
Authors: Giuliano Mariani; Laura Bruselli; Torsten Kuwert; Edmund E Kim; Albert Flotats; Ora Israel; Maurizio Dondi; Naoyuki Watanabe Journal: Eur J Nucl Med Mol Imaging Date: 2010-02-25 Impact factor: 9.236
Authors: Ora Israel; O Pellet; L Biassoni; D De Palma; E Estrada-Lobato; G Gnanasegaran; T Kuwert; C la Fougère; G Mariani; S Massalha; D Paez; F Giammarile Journal: Eur J Nucl Med Mol Imaging Date: 2019-07-04 Impact factor: 9.236