ABSTRACT
Radionuclide ventriculography or Multi Gated Acquisition (MUGA) employing [ 99m Tc]Technetium red blood cell (RBC) labeling is considered the gold standard for cardiotoxicity assessments in cancer patients undergoing chemotherapy. This in-vivo RBC labeling technique involves the reduction of [ 99m Tc]Technetium by the stannous chloride present in freeze-dried reagent kits, with the pyrophosphate kit (PYP) being the most employed for this purpose. The literature, however, describes diethylenetriaminepentaacetic acid (DTPA) as an alternative to PYP, although a lack of comparative data from MUGA images between both reagents is noted. A retrospective cross-sectional observational study was conducted at the Brazilian National Cancer Institute Nuclear Medicine Service concerning 80 randomized MUGA images, 20 obtained employing DTPA between 2020 and 2023 and 60 obtained employing PYP between 2017 and 2020, applying the mean count per pixel (ct/pixel) and heart background (C/F) ratios as quality image indicators. Although the heart ct/pixel ratio was statistically lower in the DTPA images compared with PYP ( P â =â 0.02), the C/F ratio was statistically similar when comparing both radiopharmaceuticals ( P â =â 0.697). A semi-quantitative analysis of MUGA images obtained with DTPA and PYP indicates similar image quality, supporting the use of DTPA as an alternative to PYP without compromising diagnostic interpretations.
Subject(s)
Radiopharmaceuticals , Technetium , Humans , Cross-Sectional Studies , Retrospective Studies , Radionuclide Ventriculography , Pentetic Acid , ErythrocytesSubject(s)
Takotsubo Cardiomyopathy/diagnostic imaging , Ventricular Dysfunction, Left/diagnostic imaging , 3-Iodobenzylguanidine , Aged , Echocardiography/methods , Female , Humans , Myocardial Perfusion Imaging/methods , Radiography , Radiopharmaceuticals , Takotsubo Cardiomyopathy/pathology , Ventricular Dysfunction, Left/pathologySubject(s)
Chest Pain , Myocardial Ischemia/pathology , Pain , Acute Coronary Syndrome/diagnosis , Aged , Coronary Angiography/methods , Diagnostic Imaging/methods , Humans , Male , Myocardial Perfusion Imaging/methods , Radiopharmaceuticals/pharmacology , Rest , Technetium Tc 99m Sestamibi/pharmacologySubject(s)
Bone Marrow Cells/diagnostic imaging , Coronary Vessels/diagnostic imaging , Coronary Vessels/surgery , Hematopoietic Stem Cell Transplantation/methods , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/surgery , Technetium Tc 99m Exametazime , Humans , Male , Middle Aged , Radionuclide Imaging , Radiopharmaceuticals , Treatment OutcomeABSTRACT
The authors report a case of small bowel bleeding diagnosed by Tc-99m-labeled red blood cell (RBC) scintigraphy during the postoperative period after aortic valve replacement. There is a relationship between aortic valve stenosis and gastrointestinal bleeding in elderly patients, called Heyde syndrome. The described patient had chronic anemia that worsened after surgery. RBC scintigraphy localized the source of bleeding from jejunal angiodysplasia confirmed by mesenteric angiography. This case illustrates the diagnostic information provided by RBC scintigraphy in this syndrome.