Four patients with gastrointestinal bleeding identified by a modified in vivo technique with labeled red blood cells sedimentation.
OBJECTIVE
Gastrointestinal bleeding scintigraphy (GIBS) offers the advantage of continuous monitoring of patients to localize the site of gastrointestinal bleeding. In this study, a modified in vivo labeling method with sedimentation of the labeled red blood cells (RBC) was applied to remove free technetium-99m (99mTc) and increase labeling efficiency.


METHODS
Four patients were studied. A modified in vivo RBC labeling method was used. After 10 minutes of RBC sedimentation, patients' blood plasma in the upper part of the syringe was removed, and the erythrocytes labeled with99mTc were re-administered to the patient. Serial dynamic scintiphotos were taken during the first 60 minutes. Delayed static images were acquired up to 22 hours after injection.


RESULTS
The labeling efficiency of99mTc-RBC increased up to 93%. GIBS can be performed after 20 hours post-injection and provide accurate diagnosis of gastrointestinal bleeding. No false positive findings due to free99mTc accumulation were observed for the four patients.


CONCLUSIONS
The modified in vivo method with sedimentation is a simple and effective way to increase the labeling efficiency and thus the diagnosis for the detection of gastrointestinal bleeding.
Department of Nuclear Medicine, Chung-Kang Branch, Cheng-Ching General Hospital, Taichung, Taiwan. jaywu@ym.edu.tw.
Kang-Hung
KH
Chao
Cheng-Kai
CK
Huang
Dmytro
D
Luzhbin
Jay
J
Wu
D000368:Aged; D001799:Blood Sedimentation; D003937:Diagnosis, Differential; D004912:Erythrocytes / Q000473:pathology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007553:Isotope Labeling / Q000379:methods; D008297:Male; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013667:Technetium
D019275:Radiopharmaceuticals; D013667:Technetium