Technetium-99m-labeled red blood cell scans in the investigation of gastrointestinal bleeding

Abstract

Tc99m RBC scan is effective in localizing GI bleeding when positive within the continuous phase of imaging. In this population supplemental angiography or endoscopy for the purpose of localization would seem unnecessary.

Colonoscopic management of lower gastrointestinal hemorrhage

“…In clinical practice a great deal of controversy exists regarding the value of the erythrocyte scan. Some authors have concluded that the scan is sensitive and reliable, whereas others have concluded that nuclear scintigraphy is neither accurate nor cost-effective for determining the site of GI bleeding [8][9][10][11][12][13]. We believe that diagnostic scintigraphy is useful in the localization of lower GI bleeding.…”

The SNMMI Procedure Standard/EANM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 2.0

“…Since gastrointestinal bleeding occurs intermittently, the patient should be imaged continuously for as long as practical to identify the bleeding source (10,34,(53)(54)(55). Initial imaging for a minimum of 60 min is recommended if no gastrointestinal bleeding is detected (14,19,42,52,56).…”

Therapeutic management options for patients with obscure gastrointestinal bleeding

“…Despite higher sensitivity than angiography, its role in OGIB is limited because of low accuracy in localization [Voeller et al 1991]. A delay in scanning has been shown to lead to misinterpretation of results, especially because of pooling of blood in dependent sites [Emslie et al 1996]. A Meckel's scan is a variant of technetium 99 mlabeled red blood scan, which exhibits a sensitivity of 64-100% in detecting cases of Meckel's diverticulum [Sfakianakis and Conway, 1981].…”