Effect of Severe Hypocellular Anemia on Image Quality in Equilibrium Radionuclide Angiocardiography

Equilibrium radionuclide angiocardiography (ERNA) is a highly accurate and well-established nuclear imaging modality for ventricular function evaluation. This technique exploits the binding of technetium-99m, in its reduced form, to intracellular constituents of erythrocytes - referred to as red blood cell (RBC) radiolabeling. Sufficient radiolabeling depends on an adequate number of circulating RBCs to generate optimal signal-to-background ratio and image contrast. Theoretically, a reduction in RBC count may compromise radiolabeling efficiency, culminating in suboptimal image quality. This report elucidates the deleterious effects of hypocellular anemia on ERNA imaging and documents the remarkable improvement in diagnostic image quality following targeted intervention to correct anemia.