Holzgreve Adrien, Völter Friederike, Delker Astrid, Kunz Wolfgang G, Fabritius Matthias P, Brendel Matthias, Albert Nathalie L, Bartenstein Peter, Unterrainer Marcus, Unterrainer Lena M
Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany.
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany.
Diagnostics (Basel). 2022 Feb 14;12(2):486. doi: 10.3390/diagnostics12020486.
Red blood cells (RBC) scintigraphy can be used not only for detection of bleeding sites, but also of spleen tissue. However, there is no established quantitative readout. Therefore, we investigated uptake in suspected splenic lesions in direct quantitative correlation to sites of physiologic uptake in order to objectify the readout.
20 patients with Tc-99m-labelled RBC scintigraphy and SPECT/low-dose CT for assessment of suspected splenic tissue were included. Lesions were rated as vital splenic or non-splenic tissue, and uptake and physiologic uptake of bone marrow, pancreas, and spleen were then quantified using a volume-of-interest based approach. Hepatic uptake served as a reference.
The median uptake ratio was significantly higher in splenic (2.82 (range, 0.58-24.10), = 47) compared to other lesions (0.49 (0.01-0.83), = 7), < 0.001, and 5 lesions were newly discovered. The median pancreatic uptake was 0.09 (range 0.03-0.67), bone marrow 0.17 (0.03-0.45), and orthotopic spleen 14.45 (3.04-29.82). Compared to orthotopic spleens, the pancreas showed lowest uptake (0.09 vs. 14.45, = 0.004). Based on pancreatic uptake we defined a cutoff (0.75) to distinguish splenic from other tissues.
As the uptake in extra-splenic regions is invariably low compared to splenules, it can be used as comparator for evaluating suspected splenic tissues.
红细胞（RBC）闪烁扫描不仅可用于检测出血部位，还可用于检测脾脏组织。然而，目前尚无既定的定量读数方法。因此，我们研究了疑似脾脏病变的摄取情况，并将其与生理摄取部位进行直接定量关联，以便使读数客观化。
纳入20例进行了锝-99m标记红细胞闪烁扫描及SPECT/低剂量CT以评估疑似脾脏组织的患者。将病变评定为有活性的脾脏组织或非脾脏组织，然后使用基于感兴趣区的方法对骨髓、胰腺和脾脏的摄取及生理摄取进行定量。肝脏摄取作为对照。
与其他病变（0.49（0.01 - 0.83），n = 7）相比，脾脏病变的摄取率中位数显著更高（2.82（范围0.58 - 24.10），n = 47），P < 0.001，且新发现了5个病变。胰腺摄取率中位数为0.09（范围0.03 - 0.67），骨髓为0.17（0.03 - 0.45），原位脾脏为14.45（3.04 - 29.82）。与原位脾脏相比，胰腺的摄取最低（0.09对14.45，P = 0.004）。基于胰腺摄取情况，我们定义了一个临界值（0.75）以区分脾脏组织与其他组织。
由于脾外区域的摄取与脾小结相比始终较低，因此可将其用作评估疑似脾脏组织的对照。
