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Correlation of CT Angiography and 99mTechnetium-Labeled Red Blood Cell Scintigraphy to Catheter Angiography for Lower Gastrointestinal Bleeding: A Single-Institution Experience.

Publication ,  Journal Article
Speir, EJ; Newsome, JM; Bercu, ZL; Miller, MJ; Martin, JG
Published in: J Vasc Interv Radiol
November 2019

PURPOSE: To investigate the correlation of computed tomography (CT) angiography and 99mTechnetium-labeled red blood cell (RBC) scintigraphy to catheter angiography (CA) in the management of lower gastrointestinal bleeding (LGIB) while considering potential nephrotoxic effects of iodinated contrast. MATERIALS AND METHODS: From November 2012 to August 2017, 223 CAs performed for LGIB, including massive, ongoing, and obscure bleeding, were retrospectively identified in patients with pre-procedural CT angiography or RBC scintigraphy. Positive correlations and sensitivities were calculated for CT angiography and RBC scintigraphy using CA results as reference. Correlations were then compared while considering certain clinical presentations of LGIB. Contrast dose was compared with maximum creatinine recorded 48-72 hours after. RESULTS: Thirty-eight patients underwent CT angiography; 173 patients underwent RBC scintigraphy; and 12 patients completed both studies. CT angiography had a positive correlation of 67.7% (95% confidence interval [CI]: 57.0, 76.7) and sensitivity of 85.2% (95% CI: 66.3, 95.8), whereas RBC scintigraphy had a positive correlation of 29.3% (95% CI: 27.7, 31.0) and sensitivity of 94.4% (95% CI: 84.6, 98.8). CT angiography had higher positive correlation across all clinical presentations. No dose-toxicity relationship was observed between contrast and renal function (R2: 0.008), nor was there a difference in incidence of contrast-induced nephropathy between CT angiography and RBC scintigraphy (P = .30). CONCLUSIONS: CT angiography has greater positive correlation to CA than RBC scintigraphy for assessing LGIB in active stable as well as hemodynamically unstable LGIB. As such, greater adoption of CT angiography may reduce the number of nontherapeutic CAs performed. Additional contrast associated with CT angiography does not result in increased nephrotoxicity.

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Published In

J Vasc Interv Radiol

DOI

EISSN

1535-7732

Publication Date

November 2019

Volume

30

Issue

11

Start / End Page

1725 / 1732.e7

Location

United States

Related Subject Headings

  • Young Adult
  • Sodium Pertechnetate Tc 99m
  • Risk Factors
  • Retrospective Studies
  • Reproducibility of Results
  • Radiopharmaceuticals
  • Radionuclide Imaging
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
 

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Speir, E. J., Newsome, J. M., Bercu, Z. L., Miller, M. J., & Martin, J. G. (2019). Correlation of CT Angiography and 99mTechnetium-Labeled Red Blood Cell Scintigraphy to Catheter Angiography for Lower Gastrointestinal Bleeding: A Single-Institution Experience. J Vasc Interv Radiol, 30(11), 1725-1732.e7. https://doi.org/10.1016/j.jvir.2019.04.019
Speir, Ethan J., Janice M. Newsome, Zachary L. Bercu, Michael J. Miller, and Jonathan G. Martin. “Correlation of CT Angiography and 99mTechnetium-Labeled Red Blood Cell Scintigraphy to Catheter Angiography for Lower Gastrointestinal Bleeding: A Single-Institution Experience.J Vasc Interv Radiol 30, no. 11 (November 2019): 1725-1732.e7. https://doi.org/10.1016/j.jvir.2019.04.019.
Speir, Ethan J., et al. “Correlation of CT Angiography and 99mTechnetium-Labeled Red Blood Cell Scintigraphy to Catheter Angiography for Lower Gastrointestinal Bleeding: A Single-Institution Experience.J Vasc Interv Radiol, vol. 30, no. 11, Nov. 2019, pp. 1725-1732.e7. Pubmed, doi:10.1016/j.jvir.2019.04.019.
Journal cover image

Published In

J Vasc Interv Radiol

DOI

EISSN

1535-7732

Publication Date

November 2019

Volume

30

Issue

11

Start / End Page

1725 / 1732.e7

Location

United States

Related Subject Headings

  • Young Adult
  • Sodium Pertechnetate Tc 99m
  • Risk Factors
  • Retrospective Studies
  • Reproducibility of Results
  • Radiopharmaceuticals
  • Radionuclide Imaging
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Middle Aged