title: Technetium-99m-labelled red blood cell imaging in the diagnosis of hepatic haemangiomas: the role of SPECT/CT with a hybrid camera.
abstract: Delayed liver single-photon emission computed tomography (SPECT) after (99m)Tc red blood cell (RBC) labelling is helpful in detecting hepatic haemangiomas; however, diagnosis can be difficult when lesions are situated adjacent to structures like the inferior vena cava, the heart or hepatic vessels, where blood activity persists. The aims of this study were to evaluate the usefulness of RBC SPECT and transmission computed tomography (RBC SPECT/CT) performed simultaneously with a hybrid imaging system for correct characterisation of hepatic lesions in patients with suspected haemangioma, and to assess the additional value of fused images compared with SPECT alone. Twelve patients with 24 liver lesions were studied. The acquisitions of both anatomical (CT) and functional (SPECT) data were performed during a single session. SPECT images were first interpreted alone and then re-evaluated after adding the transmission anatomical maps. Image fusion was successful in all patients, with perfect correspondence between SPECT and CT data, allowing the precise anatomical localisation of sites of increased blood pool activity. SPECT/CT had a significant impact on results in four patients (33.3%) with four lesions defined as indeterminate on SPECT images, accurately characterising the hot spot foci located near vascular structures. In conclusion, RBC SPECT/CT imaging using this hybrid SPECT/CT system is feasible and useful in the identification or exclusion of suspected hepatic haemangiomas located near regions with high vascular activity.
authors.affiliation: Department of Biopathology and Diagnostic Imaging, University Tor Vergata, Rome, Italy. oschil@tiscalinet.it
authors.forename: Orazio
authors.initials: O
authors.lastname: Schillaci
authors.forename: Roberta
authors.initials: R
authors.lastname: Danieli
authors.forename: Carlo
authors.initials: C
authors.lastname: Manni
authors.forename: Francesca
authors.initials: F
authors.lastname: Capoccetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019544:Equipment Failure Analysis; D004912:Erythrocytes / Q000000981:diagnostic imaging*; D005260:Female; D006391:Hemangioma / Q000098:blood supply* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique / Q000295:instrumentation; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D013667:Technetium