Skip Navigation LinksHome > November/December 2013 - Volume 37 - Issue 6 > Single-Photon Emission Computed Tomography/Computed Tomograp...
Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3182a604ae
Gastrointestinal Imaging

Single-Photon Emission Computed Tomography/Computed Tomography as a Problem-Solving Tool in Patients With Suspected Acute Cholecystitis

Arabi, Mohammad MD*; Brown, Richard K.J. MD*; Dwamena, Ben A. MB, ChB; Jakubowski, Eric MD*; Kim, Kyu MD*; Alvarez, Rolando MD*; Piert, Morand MD*; Frey, Kirk MD, PhD*

Collapse Box

Abstract

Aim: The aim of this study was to evaluate our institutional experience with single-photon emission computed tomography/computed tomography (SPECT/CT) hepatobiliary imaging as a problem-solving tool in the workup of suspected acute cholecystitis.

Methods: We queried our radiology information system database for cases in which SPECT/CT had been performed as part of the routine hepatobiliary technetium Tc 99m iminodiacetic acid studies done for the evaluation of acute cholecystitis. Fifty-three consecutive patients who had SPECT/CT after planar imaging were included. This cohort represents cases that were considered problematic by the initial interpreting physician on the basis of planar images. The planar and SPECT/CT images were retrospectively reviewed independently and separately by 2 experienced nuclear medicine specialists who evaluated the planar images for visualization of the gallbladder on a binary scale (yes or no) and rated their level of confidence on an ordinal scale(unsure, somewhat sure, and sure).

Results: Single-photon emission CT/CT would have led to change in the management for interpreter 1 in a total of 23 cases (41%), with change from normal to abnormal scan findings (28%) and from abnormal to normal scan findings (13%). Similarly, SPECT/CT would have led to change in the management for interpreter 2 in a total of 23 cases (43%), with change from normal to abnormal scan findings (13%) and from abnormal to normal scan findings (30%).

Conclusions: Although planar hepatobiliary scanning is usually sensitive and specific, there are occasionally problematic cases. In our experience, we found that the addition of SPECT/CT improved the interobserver agreement and may change management in patients with superimposed bowel activity and/or unusual gallbladder anatomy that can confound the planar interpretation.

© 2013 by Lippincott Williams & Wilkins

  

Login

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.