Splenic scintigraphy using Tc-99m-labeled heat-denatured red blood cells in pediatric patients: Concise communication

Journal of Nuclear Medicine (Impact Factor: 6.16). 04/1982; 23(3):209-13.
Source: PubMed


Ten children underwent splenic imaging with heat-denatured red blood cells labeled with technetium-99m (Tc-99m DRBC). The presenting problems included the heterotaxia syndrome, recurrent idiopathic thrombocytopenic purpura following splenectomy, mass in the left posterior hemithorax, and blunt abdominal trauma. In nine patients, the presence or absence of splenic tissue was established. A splenic hematoma was identified in the tenth patient. All patients were initially scanned with Tc-99m sulfur colloid (Tc-99m SC), and were selected for Tc-99m DRBC scintigraphy only after the results of the SC scans failed to establish the clinical problem beyond doubt. The availability of kits containing stannous ions, essential for efficient and stable labeling of red blood cells with Tc-99m and requiring only a small volume of blood, make splenic scintigraphy in children a relatively simple and definitive diagnostic procedure, when identification of splenic tissue is of clinical importance.

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    • "99mTc-labelled sulphur colloid scintigraphy has been used for visualisation of the phagocytic function of the liver and spleen and was once a common study for evaluating for the presence or absence of neoplastic disease, cirrhosis or portal hypertension, being largely supplanted by other modalities like ultrasonography, (PET)-CT or MRI to date [49]. For the assessment of spleen function or the presence of an accessory spleen, 99mTc-labelled, heat-altered, autologous erythrocyte scintigraphy is now recommended, because, in contrast to sulphur colloid scintigraphy, sensitivity is not hampered by the relatively high liver uptake [43–48, 50]. Sulphur colloids are captured by phagocytosis, whereas autologous, heat-altered erythrocytes are sequestrated by the normal spleen [50, 51]. "
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    ABSTRACT: Hyposplenic patients are at risk of overwhelming post-splenectomy infection (OPSI), which carries mortality of up to 70%. Therefore, preventive measures are warranted. However, patients with diminished splenic function are difficult to identify. In this review we discuss immunological, haematological and scintigraphic parameters that can be used to measure splenic function. IgM memory B cells are a potential parameter for assessing splenic function; however, more studies are necessary for its validation. Detection of Howell-Jolly bodies does not reflect splenic function accurately, whereas determining the percentage of pitted erythrocytes is a well-evaluated method and seems a good first-line investigation for assessing splenic function. When assessing spleen function, (99m)Tc-labelled, heat-altered, autologous erythrocyte scintigraphy with multimodality single photon emission computed tomography (SPECT)-CT technology is the best approach, as all facets of splenic function are evaluated. In conclusion, although scintigraphic methods are most reliable, they are not suitable for screening large populations. We therefore recommend using the percentage of pitted erythrocytes, albeit suboptimal, as a first-line investigation and subsequently confirming abnormal readings by means of scintigraphy. More studies evaluating the value of potentially new markers are needed.
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    ABSTRACT: Red blood cells labeled with 99mTc constitute a suitable intravascular agent for imaging of vascular abnormalities. Hemangiomas are characterized by low perfusion and a high blood pool. This "perfusion blood-pool mismatch," not encountered in other lesions, may help in the specific diagnosis of this tumor. This is particularly so in cavernous hemangiomas of the liver where three-phase 99mTc-labeled red blood cell scintigraphy should precede liver biopsy. Red cell scintigraphy also is useful for establishing the vascular nature of hemangiomas of the head and neck and the skin and for diagnosis of venous occlusion. Heat-damaged red blood cells provide a specific spleen imaging agent. This should be used when patients with suspected splenic pathology have equivocal colloid scintigraphy.
    No preview · Article · Aug 1984 · Seminars in Nuclear Medicine
  • Chapter: Liver
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    ABSTRACT: Hepatic scintigraphy in children presents certain special problems because of the types of diseases usually encountered and the wide range of body sizes in the pediatric population. The principles, technique, and interpretation of hepatic scintigraphy using technetium-99m (Tc-99m) sulfur colloid are presented in this chapter. Hepatobiliary scintigraphy and splenic scintigraphy are discussed in other chapters.
    No preview · Chapter · Jan 1985
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