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The Diagnostic Contribution of SPECT/CT Imaging in the Assessment of Gastrointestinal Bleeding: Especially for Previously Operated Patients

Authors
  • Soyluoğlu, Selin1
  • Korkmaz, Ülkü1
  • Özdemir, Büşra1
  • Durmuş Altun, Gülay1
  • 1 Trakya University Faculty of Medicine, Department of Nuclear Medicine, Edirne, Turkey
Type
Published Article
Journal
Molecular Imaging and Radionuclide Therapy
Publisher
Galenos Publishing
Publication Date
Feb 09, 2021
Volume
30
Issue
1
Pages
8–17
Identifiers
DOI: 10.4274/mirt.galenos.2020.24392
PMID: 33586402
PMCID: PMC7885275
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Green

Abstract

Objectives: Gastrointestinal bleeding (GIB) is a life-threatening problem that requires a multidisciplinary approach for successful treatment. This study aims to emphasize the clinical contribution of single photon emission computed tomography/computed tomography (SPECT/CT) for the diagnosis of acute bleeding. Methods: All 14 patients referred to the nuclear medicine department in 3 years with suspicion of acute GIB were evaluated retrospectively. Clinical records were analyzed to assess the scintigraphic findings, emphasizing the correlative contribution of the CT portion on SPECT/CT studies. Results: Five patients were negative on dynamic and static planar images. SPECT/CT was performed in 9 patients who had positive findings on planar imaging. SPECT/CT could identify the same bleeding site originating from the anastomosis in four patients with a history of abdominal surgery. SPECT/CT confirmed bleeding from the cecum in a patient with cervical cancer. SPECT/CT showed the bleeding focus in the bladder neck of a patient with bladder cancer and the bleeding from peritoneal metastases of a patient with gastric cancer. In 1 patient, the right upper quadrant activity accumulation, which may cause false positives, was found to be the gallbladder on SPECT/CT. Delayed images showed the true bleeding focus in the cecum. In 1 patient, suspicious activity accumulation in the midline of the abdomen was found to be due to a previously unknown aortic aneurysm on SPECT/CT. Conclusion: SPECT/CT imaging is a feasible technique to facilitate image interpretation in patients with GIB. SPECT/CT imaging can guide the surgeon through more accurate localization. Therefore, for proper patient management, SPECT/CT should be applied to detect the bleeding focus, if present, especially in patients who had undergone a previous operation.

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