title: Diagnostic ability of (99m)Tc-HSA-DTPA scintigraphy in combination with SPECT/CT for gastrointestinal bleeding.
abstract: OBJECTIVE
  Gastrointestinal (GI) bleeding scintigraphy in combination with single-photon emission computed tomography/computed tomography (SPECT/CT) remains to be studied in detail. This study aimed to examine the diagnostic ability of this tool.
  
  
  METHODS
  GI bleeding scintigraphy using (99m)Tc-human serum albumin-diethylenetriaminepentaacetic acid was performed for 38 patients with suspected GI bleeding. Twenty-four patients were diagnosed using planar images alone (planar group) and 14 patients were diagnosed using planar images and additional SPECT/CT images (planar + SPECT/CT group). The diagnostic ability of each method was analyzed.
  
  
  RESULTS
  GI bleeding was observed in 20 of the 38 patients. For the existence of GI bleeding, planar images alone showed a sensitivity of 70%, specificity of 93%, positive predictive value (PPV) of 88%, negative predictive value (NPV) of 81%, and an overall accuracy of 83%, whereas planar images + SPECT/CT showed a sensitivity of 100%, specificity of 75%, PPV of 91%, NPV of 100%, and an overall accuracy of 93%. The source of bleeding was accurately diagnosed in 50% in the planar group and 78% in the planar + SPECT/CT group. In the planar + SPECT/CT group, 44% of the evaluable patients showed correct localization of the source of GI bleeding by additional SPECT/CT images, although planar images only showed incorrect localization.
  
  
  CONCLUSIONS
  GI bleeding scintigraphy in combination with SPECT/CT is a noninvasive and useful tool for the examination of GI bleeding.
authors.affiliation: Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan, kouhei-k@med.osaka-cu.ac.jp.
authors.forename: Kohei
authors.initials: K
authors.lastname: Kotani
authors.forename: Joji
authors.initials: J
authors.lastname: Kawabe
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Higashiyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Etsushi
authors.initials: E
authors.lastname: Kawamura
authors.forename: Hideki
authors.initials: H
authors.lastname: Kawahata
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamanaga
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Katayama
authors.forename: Susumu
authors.initials: S
authors.lastname: Shiomi
mesh_terms: D000368:Aged; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate