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Evaluation of Usefulness of SPECT-CT at the Examination of Digestive System Leakage Patients  

Ham, Jun Cheol (Dept. of Nuclear Medicine, Yonsei University Health System)
Oh, Shin Hyun (Dept. of Nuclear Medicine, Yonsei University Health System)
Choi, Yong Hoon (Dept. of Nuclear Medicine, Yonsei University Health System)
Kang, Chun Koo (Dept. of Nuclear Medicine, Yonsei University Health System)
Kim, Jae Sam (Dept. of Nuclear Medicine, Yonsei University Health System)
Publication Information
The Korean Journal of Nuclear Medicine Technology / v.22, no.1, 2018 , pp. 98-102 More about this Journal
Abstract
Purpose When examining patients with digestive system Leakage, it is not easy to distinguish between bile leakage and bleeding only with Planar images. I would like to evaluate the utility of leakage of bile, confirmation of gastrointestinal bleeding and location discrimination using SPECT-CT. Materials and Methods SPECT-CT was performed according to the request of the reading room after acquiring Planar image for a total of 13 patients, including 8 patients suspected of bile leakage and 5 patients suspected of gastrointestinal bleeding, among patients visiting this specification went. We used Symbia T16 from SIEMENS and Discovery 670 from GE. Planar and SPECT-CT images were evaluated with a score of 1 to 10 by 4 experienced nuclear medicine doctors. Using the sensitivity and the specificity, the evaluation of the inspection by the ROC curve was carried out. The final diagnosis was confirmed by follow-up observation as a result of reoperative surgery. Results The sensitivity, specificity and accuracy of SPECT-CT were 91.7%, 100% and 94.2%, respectively. Planar images were 83.3%, 68.8% and 78.8%, respectively. Planar images showed lower diagnostic accuracy compared to SPECT-CT (78.8%, 94.2%, p<0.05). Moreover, the reliability of the diagnosis of SPECT-CT by ROC curve analysis showed a more useful result than the Planar image (p<0.05). Conclusion SPECT-CT had high sensitivity and specificity for diagnosis of biliary leakage and gastrointestinal bleeding and location discrimination. When SPECT-CT is additionally performed together with Planar images, it may be considered to improve bile leakage and diagnosis of gastrointestinal bleeding patients and position discrimination evaluation. There is usefulness depending on the patient's age and position, but consideration of additional CT exposure may be done sufficiently.
Keywords
leakage of bile; gastrointestinal bleeding; Planar; SPECT-CT;
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1 고창순, 핵의학. 제 3판. 고려의학 2008. P1.
2 Mochizuki T, Tauxe WN, Dobkin J, et al. Detection of complications after liver transplantation by technetium-99m mebrofenin hepatobiliary scintigraphy. Ann Nucl Med. 1991;5:103-107.   DOI
3 Tan KG, Bartholomeusz FD, Chatterton BE. Detection and follow up of biliary leak on Tc-99m DIDA SPECT-CT scans. Clin Nucl Med. 2004;29:642-643.   DOI
4 Fleming KW, Lucey BC, Soto JA, Oates ME. Posttraumatic bile leaks: role of diagnostic imaging and impact on patient outcome. Emerg Radiol. 2006;12:103-107.   DOI
5 Mark Tulchinsky, Brian W. Ciak, Dominique Delbeke, Andrew Hilson, Kelly Anne Holes-Lewis, Michael G. Stabin, and Harvey A. Ziessman: SNM Practice Guideline for Hepatobiliary Scintigraphy 4.0. Journal of Nuclear Medicine Technology. Vol. 38. No. 4. December 2010;38:210-218.   DOI
6 Sasikumar Arun, Sampath Santhosh, Ashwani Sood, Anish Bhattacharya and Bhagwant R. Mittal: Added value of SPECT/CT over planar Tc-99m mebrofenin hepatobiliary scintigraphy in the evaluation of bile leaks. Nuclear Medicine Communications 2013, 34:459-466.   DOI
7 Punit Sharma, Rakesh Kumar, Kalpa Jyoti Das, Harmandeep Singh, Sujoy Pal,Rajinder Parshad, Chandrasekhar Bal, Guru Pada Bandopadhyaya, Arun Malhotra:Detection and localization of post-operative and post-traumatic bile leak: hybrid SPECT-CT with $^{99m}Tc$-Mebrofenin Abdominal Imaging (2012) 37:803-811.   DOI