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The diagnostic ability of SPECT/CT fusion imaging for gastrointestinal bleeding: a retrospective study
Yoichi Otomi1, Hideki Otsuka2,3, Kaori Terazawa1
1Department of Radiology, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan.
Insights
Single-photon emission computed tomography/computed tomography (SPECT/CT) imaging offers superior accuracy in pinpointing gastrointestinal bleeding sites compared to planar imaging alone or planar imaging with SPECT. This advanced technique improves diagnostic localization for acute gastrointestinal bleeding.
Area of Science:
- Nuclear Medicine
- Diagnostic Imaging
- Gastroenterology
Background:
- Gastrointestinal bleeding is a critical medical emergency requiring accurate detection and localization.
- Effective diagnosis of gastrointestinal bleeding is essential for timely and appropriate patient management.
- Current imaging modalities have varying capabilities in identifying bleeding sources.
Purpose of the Study:
- To retrospectively evaluate the diagnostic performance of SPECT/CT in gastrointestinal bleeding.
- To compare SPECT/CT with planar imaging and planar imaging plus SPECT for bleeding detection and localization.
- To determine the optimal imaging technique for diagnosing gastrointestinal bleeding.
Main Methods:
- Retrospective analysis of 20 patients (21 examinations) who underwent gastrointestinal bleeding scintigraphy.
- Categorization into three groups: planar imaging, planar imaging + SPECT, and planar imaging + SPECT/CT.
- Comparison of sensitivity, specificity, and accuracy in detecting bleeding presence and localization.
Main Results:
- All methods demonstrated high accuracy in detecting the presence of gastrointestinal bleeding.
- Planar + SPECT/CT achieved 100% sensitivity and accuracy in detecting bleeding presence.
- Localization accuracy significantly improved with SPECT/CT: planar (33.3%), planar + SPECT (71.4%), planar + SPECT/CT (100%).
Conclusions:
- SPECT/CT significantly enhances the anatomical localization of gastrointestinal bleeding sites.
- The addition of SPECT or SPECT/CT clarifies the uptake position, aiding in precise bleeding source identification.
- Planar + SPECT/CT imaging provides the highest diagnostic capability for localizing gastrointestinal bleeding.
Background:
Blood loss from the gastrointestinal tract can be an acute and life-threatening event. For the treatment of gastrointestinal bleeding, it is important to accurately detect gastrointestinal bleeding and to localize the sites of bleeding. The purpose of this study was to retrospectively assess the capabilities of SPECT/CT in the diagnosis of gastrointestinal bleeding by a comparison with planar imaging alone as well as planar and SPECT.
Methods:
We conducted a retrospective analysis of 20 patients (21 examinations) who underwent gastrointestinal bleeding scintigraphy in the past 7 years and in whom the bleeding site was identified by endoscopy or capsule endoscopy, or in whom no evidence of gastrointestinal bleeding was identified during the clinical course. Five patients (5 examinations) were diagnosed by planar imaging (planar group). Eight patients (9 examinations) were diagnosed by planar imaging and SPECT (planar + SPECT group). Seven patients (7 examinations) were diagnosed by planar imaging and SPECT/CT (planar + SPECT/CT group). We calculated the diagnostic ability of each method in detecting the presence of bleeding, as well as the ability of each method to identify the sites of bleeding. The sensitivity, specificity, and accuracy of the methods were compared.
Results:
The diagnostic ability of the three imaging methods in detecting the presence of gastrointestinal bleeding was as follows. Planar imaging showed 100% sensitivity (3/3), 100% specificity (2/2), and 100% accuracy (5/5). Planar + SPECT imaging showed 85.7% sensitivity (6/7), 100% specificity (2/2), and 88.9% accuracy (8/9). Planar + SPECT/CT imaging showed 100% sensitivity (6/6), 100% specificity (1/1), and 100% accuracy (7/7). The diagnostic ability of the three modalities in detecting the site of bleeding was as follows: planar, 33.3% (1/3); planar + SPECT, 71.4% (5/7); and planar + SPECT/CT, 100% (6/6).
Conclusions:
All 3 imaging methods showed good accuracy in detecting the presence of gastrointestinal bleeding. The addition of SPECT or SPECT/CT made the anatomical position of the uptake clear and contributed to the localization of the site of gastrointestinal bleeding. Planar + SPECT/CT imaging therefore showed the highest diagnostic ability for detecting the site of gastrointestinal bleeding.
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