Technological value of SPECT/CT fusion imaging for the diagnosis of lower gastrointestinal bleeding

Abstract

ABSTRACT. The aim of this study was to assess the clinical value of diagnosing and locating lower gastrointestinal (GI) bleeding using single photon emission computed tomography (SPECT)/computed tomography (CT) fusion imaging with 99mTc labeled red blood cells ( 99m Tc-RBC). Fifty-six patients with suspected lower GI bleeding received a preoperative intravenous injection of 99m Tc-RBC and each underwent planar, SPECT/CT imaging of the lower abdominal region. The location and path of lower GI bleeding were diagnosed by contrastive analysis of planar and SPECT/CT fusion imaging. Among the 56 patients selected, there were abnormalities in concentrated radionuclide activity with planar imaging in 50 patients and in SPECT/ CT fusion imaging in 52 patients. Moreover, bleeding points that were coincident with the surgical results were evident with planar imaging in 31 patients and with SPECT/CT fusion imaging in 48 patients. The diagnostic sensitivity of planar imaging and SPECT/CT fusion imaging were 89.3% (50/56) and 92.9% (52/56), respectively, and the difference Z.G. Wang et al. 14948©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (4): 14947-14955 (2015) was not statistically significant (χ 2 = 0.11, P > 0.05). The corresponding positional accuracy values were 73.8% (31/42) and 92.3% (48/52), and the difference was statistically significant (χ 2 = 4.63, P < 0.05). 99mTc-RBC SPECT/CT fusion imaging is an effective, simple, and accurate method that can be used for diagnosing and locating lower GI bleeding.

Design of erythrocyte-derived carriers for bioimaging applications

“…These labelled erythrocytes can be imaged using both planar imaging and single-photon emission computed tomography (SPECT) [58]. Upon intravenous administration of labelled erythrocytes along with the use of SPECT/CT fusion imag ing techniques, sites of lower gastrointestinal bleeding in patients were successfully detected [58]. This demonstrates the clinical prospects of ECs in diagnosis and provides grounds for the optimisation of EIAs designed for different imaging modalities for clinical trials.…”

“…Currently, the clinical applications of EIAs largely occur during blood pool imaging, such as autologous human erythrocytes labelled with 99m Tc pertechnetate. These labelled erythrocytes can be imaged using both planar imaging and single-photon emission computed tomography (SPECT) [58]. Upon intravenous administration of labelled erythrocytes along with the use of SPECT/CT fusion imag ing techniques, sites of lower gastrointestinal bleeding in patients were successfully detected [58].…”

Two decades of SPECT/CT – the coming of age of a technology: An updated review of literature evidence

“…Positive studies identify patients who need immediate treatment if the site of bleeding is localized [236]. SPECT/ CT was found to improve bleeding source localization in over 30% of cases [237] and, increased sensitivity from 89% to 93% compared to planar scans, with improved positional accuracy of the bleeding site in 92% vs. 74% of patients [238]. Timing of 99m Tc-RBC SPECT/CT acquisition needs further evaluation.…”

In vivo positron emission tomographic blood pool imaging in an immunodeficient mouse model using 18F-fluorodeoxyglucose labeled human erythrocytes

“…Clinical blood pool imaging is commonly performed in nuclear medicine departments using autologous human erythrocytes labeled with the radiotracer 99m-Technetium ( 99m Tc) pertechnetate and gamma scintigraphic imaging. The current prevalent clinical indications for 99m Tc-labeled erythrocyte imaging are the detection of drug-induced cardiomyopathy in cancer patients undergoing potentially cardiotoxic chemotherapy, and anatomic localization of sites of occult lower intestinal bleeding in patients [1–3]. While planar imaging of 99m Tc-labeled erythrocytes is the most commonly utilized nuclear medicine blood pool imaging test, ECG-gated single-photon emission computed tomographic (SPECT) imaging of 99m Tc-labeled erythrocytes has also been used for radionuclide ventriculography, demonstrating comparable results to planar blood pool imaging [4–6].…”