Gallbladder visualization during technetium-99m RBC blood pool imaging. Case report and literature review

Area of Science:

• Nuclear Medicine
• Diagnostic Imaging
• Radiopharmaceuticals

Background:

• Technetium-99m red blood cell (Tc-99m RBC) scans are utilized for various diagnostic purposes, including cardiac imaging and gastrointestinal (GI) bleeding detection.
• Gallbladder visualization during Tc-99m RBC scans is an uncommon but reported phenomenon.
• Previous cases have primarily identified gallbladder visualization incidentally during investigations for GI bleeding.

Observation:

• This report details a case of gallbladder visualization following a Tc-99m RBC cardiac gated blood pool scan.
• Seven cases of gallbladder visualization after Tc-99m RBC injection have been documented.
• In prior instances, gallbladder visualization was an incidental finding during GI bleeding assessments.

Findings:

• The patients in previous reports frequently presented with anemia, chronic renal failure, and a history of multiple blood transfusions.
• These patient characteristics may be associated with the observed gallbladder visualization.
• The mechanism underlying gallbladder visualization in these specific clinical contexts requires further investigation.

Implications:

• Clinicians interpreting GI bleeding scans in anemic patients with renal failure must be aware of potential gallbladder visualization.
• This awareness is essential to prevent misinterpretation and avoid false-positive results on delayed imaging.
• Further research may elucidate the specific pathophysiological reasons for gallbladder visualization in patients with these comorbidities.