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Tc-99m Sulfur Colloid and Tc-99m Tagged Red Blood Cell Methods Are Comparable for Detecting Lower Gastrointestinal Bleeding in Clinical Practice

PONZO, FABIO, M.D.; ZHUANG, HONGMING, M.D., PH.D.; LIU, FRANK M., M.D.; LACORTE, LESTER B., M.D.; MOUSSAVIAN, BAHAR, M.D.; WANG, SUNNY, B.S.; ALAVI, ABASS, M.D.

Original Articles
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Purpose  The objective of this study was to determine whether the Tc-99m red blood cells (Tc-99m RBC) method has a true advantage over the Tc-99m sulfur colloid (Tc-99m SC) technique in a busy clinical practice for detecting and localizing lower gastrointestinal bleeding sites.

Methods  Three hundred fifty-nine consecutive gastrointestinal bleeding studies performed during the past 4 years were reviewed retrospectively. One hundred ninety-three scans were obtained with Tc-99m SC (scan duration, 30 minutes) and 138 studies were performed after the administration of Tc-99m RBC (scan duration, 1 hour). In addition, 28 examinations with Tc-99m SC were followed immediately by Tc-99m RBC scans for a duration of several hours. The results of the two methods were analyzed and the performance of the two techniques was compared.

Results  Among 193 scans performed using the Tc-99m SC method, 47 (24.4%) successfully identified the location of the bleeding site, whereas in 138 scans performed using Tc-99m RBC, 38 (27.5%) were successful for this purpose. In the remaining 28 scans in which the Tc-99m SC scan was followed by the Tc-99m RBC study, only 4 (14.3%) positive bleeding sites were identified after a prolonged imaging period.

Discussion The theoretical advantages of the Tc-99m RBC technique compared with the Tc-99m SC method cannot be substantiated by this study. Our findings suggest that the efficacy of these two methods is nearly equal at a practical level.

Conclusion  The simpler and cost-effective Tc-99m SC method is as efficient as the Tc-99m RBC method when the scanning time is limited to 1 hour and optimal imaging and interpretation schemes are used.

From the Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Received for publication December 3, 2001.

Accepted January 14, 2002.

Reprint requests: Abass Alavi, Division of Nuclear Medicine, Hospital of the University of Pennsylvania, 110 Donner Building, 3400 Spruce Street, Philadelphia, Pennsylvania 19104. E-mail: ALAVI@OASIS.RAD.UPENN.EDU

© 2002 Lippincott Williams & Wilkins, Inc.