Skip to main content
SpringerLink
Log in

Sequential subtraction scintigraphy with99mTc-RBC for the early detection of gastrointestinal bleeding

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

To improve the early detectability of gastrointestinal (GI) bleeding, we have developed a new subtraction scintigraphic technique usingin vivo labeled99mTc red blood cells (RBC). Use of this new sequential subtraction method every 5 min makes it possible to detect early the bleeding site and calculate the bleeding rate. In phantom experiments, focal activity was detected on subtraction images at pump rates of more than 0.20 ml/min at any urethane thickness, but was negative on conventional scintigrams. The calculated pump rate by the subtraction method correlated well with the actual syringe pump rate (y = 1.07x-0.02, r = 0.99, p < 0.01) in the case of an 8-cm urethane board as an abdominal wall. Twenty-four of 50 patients with suspected GI bleeding were confirmed to be positive within 24 hr. The subtraction method showed 15 true positive and 2 false positive cases within 60 min. On the other hand, the conventional scintigraphic method showed only 7 true positive and 1 false positive cases. Sensitivity of the subtraction method was 62.5%, which was significantly higher (p < 0.05) than that of the conventional scintigraphic method (29.2%).

These results suggest that sequential subtraction scintigraphy with99mTc-RBC is an effective method for the early detection of GI bleeding and shortening the examination time as compared with conventional scintigraphy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sos TA, Lee JG, Wixson D, Sniderman KW. Intermittent bleeding from minute to minute in acute massive gastrointestinal hemorrhage: arteriographic demonstration.Am J Roentgenol 131: 1015–1017, 1978.

    CAS  Google Scholar 

  2. Winzelberg GG, McKusick KA, Strauss HW, Watsan AC, Greenfield AJ. Evaluation of gastrointestinal bleeding by red blood cells labeledin vivo with technetium-99m.J Nucl Med 20: 1080–1086, 1979.

    CAS  PubMed  Google Scholar 

  3. McKusick KA, Froelich JW, Callahan RJ, Winzelberg GG, Strauss HW.99mTc-red blood cells for detection of gastrointestinal bleeding: experience with 80 patients.Am J Roentgenol 137: 1113–1118, 1981.

    CAS  Google Scholar 

  4. Miskowiak J, Nielson SL, Munck O. Scintigraphic diagnosis of gastrointestinal bleeding with99mTc-Iabeled blood pool agents.Radiology 141: 499–504, 1981.

    CAS  PubMed  Google Scholar 

  5. Bunker SR, Lull RJ, Tanasescu DE, Redwine MD, Rigby MD, Brown JM, et al. Scintigraphy of gastrointestinal hemorrhage: superiority of99mTc red blood cells over99mTc sulfur colloid.Am J Roentgenol 143: 543–548, 1984.

    CAS  Google Scholar 

  6. Smith R, Copely DJ, Bolen FH.99mTc RBC scintigraphy: correlation of gastrointestinal bleeding rates with scintigraphic findings.Am J Roentgenol 148: 869–874, 1987.

    CAS  Google Scholar 

  7. Akashi T, Aizawa N, Suzuki Y, Tsuda K, Moriya T, Mitsui T. Clinical evaluation of technetium-99m labeled red blood cell scan in the detection of gastrointestinal hemorrhage.KAKU IGAKU (Jpn J Nucl Med) 25: 23–29, 1988 (in Japanese).

    CAS  Google Scholar 

  8. Maurer AH, Rodman MS, Vitti RA, Revez G, Krevsky B. Gastrointestinal bleeding: improved localization with cine scintigraphy.Radiology 185: 187–192, 1992.

    CAS  PubMed  Google Scholar 

  9. Pavel DG, Zimmer AM, Patterson VN.In vivo labeling of red blood cells with99mTc: a new approach to blood pool visualization.J Nucl Med 18: 305–308, 1977.

    CAS  PubMed  Google Scholar 

  10. D’Addabbo A, Fersini M. Detection of intra-abdominal bleeding by radioisotope scanning after experimental etravasation.J Nucl Biol Med 18: 170–174, 1974.

    PubMed  Google Scholar 

  11. Miskowiak J, Nielssen SL, Munck O, Andersen B. Abdominal scintiphotography with99mtechnetium-labelled albumin in acute gastrointestinal bleeding.Lancet 2: 852–854, 1977.

    Article  CAS  PubMed  Google Scholar 

  12. Alavi A, Dann RW, Baum S, Biery DN. Scintigraphic detection of acute gastrointestinal bleeding.Radiology 124: 753–756, 1977.

    CAS  PubMed  Google Scholar 

  13. Alavi A. Detection of gastrointestinal bleeding with99mTc-sulfur colloid.Semin Nucl Med 12: 126–138, 1982.

    Article  CAS  PubMed  Google Scholar 

  14. Robinson P. The role of nuclear medicine in acute gastrointestinal bleeding.Nucl Med Commu 14: 849–855, 1993.

    Article  CAS  Google Scholar 

  15. Chandeysson PL, Hanson RJ, Watson CE, Henesy GT. Minimal gastrointestinal bleeding rate detected by abdominal scintigraphy.J Nucl Med 24: 97, 1983 (abstr).

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Toyama Medical and Pharmaceutical University Hospital, 2630 Sugitani, 930-01, Toyama, Japan

    Hikaru Seto, Masanari Kageyama, Yi-wei Wu, Masashi Shimizu, Toshiro Nagayoshi, Naoto Watanabe, Kuninori Nomura & Masao Kakishita

Authors
  1. Hikaru Seto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masanari Kageyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yi-wei Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masashi Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toshiro Nagayoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naoto Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kuninori Nomura
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masao Kakishita
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Seto, H., Kageyama, M., Wu, Yw. et al. Sequential subtraction scintigraphy with99mTc-RBC for the early detection of gastrointestinal bleeding. Ann Nucl Med 9, 203–208 (1995). https://doi.org/10.1007/BF03168402

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03168402

Key words

Search

Navigation