Diagnostic value of 99m Tc-labeled red blood cell single photon emission tomography for the diagnosis of liver hemangiomas

ABSTRACT

Technetium-99m red blood cell scintigraphy is a very specific method to differentiate a hemangioma from other hepatic masses. The purpose of this study is to evaluate the efficacy of planar scintigraphy and single photon emission computed tomography Technetium-99m-labeled red blood cell in the investigation of suspected hepatic cavernous hemangioma. The study group consisdered of one hundred and five patients, 62 females [59%] and 43 males [41%], between 23-69 years of age [mean age of 41]. These patients were evaluated for liver masses found on ultrasound. The final diagnosis was made after liver biopsy or aspiration cytology in 26 patients and after folow-up by maintaining stable clinical course ranging for one year with no changes in the size or appearance of the lesion on ultrasound in 79 patients. One hundred and thirty two lesions were found; hemangioma in 96 patients and non-hemangiomatous lesions in 36 patients. Planar[99m] Tc-red blood cell showed sensitivity and specificity of 67% and 100% respectively, while [99m] Tc-red blood cell-single photon emission computed tomography showed sensitivity and specificity of 81%, 97% respectively. The use of single photon emission computed tomography showed better sensitivity value than PS from hemangiomas < 2.5 cm [61% for single photon emission computed tomography versus 24% for planar scintigraphy]. Tc-99m RBC scintigraphy is a simple, noninvasive and accurate technique in the detection of hepatic hemangioma. It can distinguish from other hepatic lesions. Single photon emission computed tomography is superior to planar imaging in the detection of small hemangioma and should be performed whenever planar imaging fails to show the lesion by 2 hours. Lesions less than 1.1 cm cannot be detected by Tc-99m red blood single photon emission computed tomography because they are beyond the limit of spatial resolution of the gamma camera used