The SNMMI Procedure Standard/EANM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 2.0

Dam, Hung; Brandon, David; Grantham, Vesper; Hilson, A. J.W.; Howarth, Douglas M.; Maurer, Alan H.; Stabin, Michael G.; Tülchinsky, Mark; Ziessman, Harvey A.; Zuckier, Lionel S.

doi:10.2967/jnmt.114.147959

Cited by 45 publications

(37 citation statements)

References 106 publications

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“… 2 Among nuclear medicine procedures, 99m Tc-red blood cell (RBC) scintigraphy is also known as a sensitive method for detection and localization of intestinal bleeding. 3 Despite using variable imaging techniques, some patients still may remain undiagnosed usually because of small amount or intermittent nature of intestinal bleeding. 2 Our patient had also undergone many work-ups during 3 years with no effective results gained.…”

Section: Introductionmentioning

confidence: 99%

Importance of Heparin Provocation and SPECT/CT in Detecting Obscure Gastrointestinal Bleeding on 99mTc-RBC Scintigraphy

2015

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We presented a pediatric case with a history of intermittent melena for 3 years because of angiodyplasia of small intestine. The results of frequent upper gastrointestinal endoscopies and colonoscopies as well as both 99mTc-red blood cell (RBC) and Meckel's scintigraphies for several times were negative in detection of bleeding site. However, 99mTc-RBC scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) after heparin augmentation detected a site of bleeding in the distal ileum which later was confirmed during surgery with final diagnosis of angiodysplasia.It could be stated that heparin provocation of bleeding before 99mTc-RBC scintigraphy accompanied by fused SPECT/CT images should be kept in mind for management of intestinal bleeding especially in difficult cases.

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Section: Introductionmentioning

confidence: 99%

Importance of Heparin Provocation and SPECT/CT in Detecting Obscure Gastrointestinal Bleeding on 99mTc-RBC Scintigraphy

2015

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“…The second option, observation with clinical and laboratory evaluation and, if possible, using Doppler ultrasonography, catheter or CT angiography, or scintigraphy to evaluate a further consideration of the bowel vascularization and viability, does not seem practicable due to the inability of the routine clinical and laboratory ischemia parameters to accurately diagnose ischemia,1,2,4,9 in addition to the uncommon use of some of those advanced techniques and the corresponding inexperience with their usage in SV 11,12. Although it is possible to evaluate the lower intestinal vascularization as well as several other diseases, including bleeding, using those techniques, and experiments have been performed,13-15 there is no report of their usage in sigmoid volvulus in the literature,11,12 which is similar to our own inexperience. The probability of missing bowel gangrene and/or the development of toxic shock during an observation period of a few hours or days represents another disadvantage of this approach.…”

Section: Discussionmentioning

confidence: 88%

“…In this approach, the treatment is directed according to the results of the criteria mentioned above. Additionally, if possible, advanced diagnostic techniques such as ultrasonography,13 angiography14 or scintigraphy15 may be used in the determination of the bowel vascularization and viability. The last method is performing a second look endoscopy after an observation period of a few hours.…”

Section: Introductionmentioning

confidence: 99%

What is done when endoscopic examination reveals borderline bowel ischemia in patients with sigmoid volvulus?

Atamanalp

2017

Pak J Med Sci

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Sigmoid volvulus (SV) is a rare colonic obstruction in which the sigmoid colonwraps around itself. The principal strategy for the treatment of uncomplicated SV is emergency endoscopic detorsion, while emergency surgery is needed in complicated SV with bowel gangrene, bowel perforation, peritonitis, or unsuccessful endoscopic treatment. In the endoscopic examination of SV, endoscopic detorsion is performed if the bowels are viable, while emergency surgery is needed if the bowels are gangrenous. However, the treatment approach is not clear when endoscopic examination reveals borderline bowel ischemia, and in this short report, the possible treatment strategies are discussed.

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“…Timing of 99m Tc-RBC SPECT/CT acquisition needs further evaluation. There is also concern that during the relatively long SPECT/CT acquisition, patient motion or bowel artefacts can affect correct localization of the bleeding site [239,240].…”

Section: Gastrointestinal Tractmentioning

confidence: 99%

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

Israel

Pellet

Biassoni

et al. 2019

Eur J Nucl Med Mol Imaging

163

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Purpose Single-photon emission computed tomography (SPECT) combined with computed tomography (CT) was introduced as a hybrid SPECT/CT imaging modality two decades ago. The main advantage of SPECT/CT is the increased specificity achieved through a more precise localization and characterization of functional findings. The improved diagnostic accuracy is also associated with greater diagnostic confidence and better inter-specialty communication. Methods This review presents a critical assessment of the relevant literature published so far on the role of SPECT/CT in a variety of clinical conditions. It also includes an update on the established evidence demonstrating both the advantages and limitations of this modality. Conclusions For the majority of applications, SPECT/CT should be a routine imaging technique, fully integrated into the clinical decision-making process, including oncology, endocrinology, orthopaedics, paediatrics, and cardiology. Large-scale prospective studies are lacking, however, on the use of SPECT/CT in certain clinical domains such as neurology and lung disorders. The review also presents data on the complementary role of SPECT/CT with other imaging modalities and a comparative analysis, where available.

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The SNMMI Procedure Standard/EANM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 2.0

Cited by 45 publications

References 106 publications

Importance of Heparin Provocation and SPECT/CT in Detecting Obscure Gastrointestinal Bleeding on 99mTc-RBC Scintigraphy

Importance of Heparin Provocation and SPECT/CT in Detecting Obscure Gastrointestinal Bleeding on 99mTc-RBC Scintigraphy

What is done when endoscopic examination reveals borderline bowel ischemia in patients with sigmoid volvulus?

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

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