Quantitative evaluation of postembolized splenic tissue using technetium-99m sulfur colloid.

Area of Science:

• Nuclear Medicine
• Radiology
• Transplant Surgery

Background:

• Hypersplenism can complicate renal transplant outcomes.
• Partial splenic embolization (PSE) is a treatment option for hypersplenism.
• Accurate quantification of splenic tissue post-PSE is crucial for assessing treatment efficacy.

Purpose of the Study:

• To evaluate the accuracy of Technetium-99m sulfur colloid scintigraphy in quantifying residual splenic tissue after PSE.
• To compare the precision of this nuclear medicine technique with computed tomography (CT) and magnetic resonance imaging (MRI).

Main Methods:

• Developed and validated a liver-spleen phantom simulating human anatomy for Tc-99m sulfur colloid imaging.
• Utilized lucite pseudo-emboli to precisely displace known volumes within the spleen phantom.
• Analyzed computer-generated images from the phantom and 17 renal transplant patients undergoing PSE.

Main Results:

• A high correlation (0.996, P < 0.001) was found between actual displaced splenic volume and computer-estimated values.
• The Tc-99m sulfur colloid scan technique demonstrated superior precision compared to CT and MRI.
• The nuclear medicine method was less complex to perform than CT or MRI for this specific measurement.

Conclusions:

• Tc-99m sulfur colloid scintigraphy provides a precise and reliable method for quantifying residual splenic tissue post-PSE.
• This technique offers advantages in accuracy and ease of performance over CT and MRI for assessing post-embolization splenic volume.
• Accurate splenic volume assessment aids in managing hypersplenism in renal transplant recipients.