RBC Liver (Liver Blood Pool)

Indication:
  • Cavernous Hemangiomas
  • assessing size, shape and position of the liver and spleen
  • liver lesions

Contraindications: n/a

Radiopharmaceutical information:
  • Radionuclide: Tc-99 m
  • Radiopharmaceutical: Tc-99 m pertechnetate
  • Adult dosing: 25 mCi
  • Pediatric dosing: 0.2–0.3 mCi (snm.org)
  • Method of administration: Inject intravenously
  • Method of Localization: Compartmental
  • Physical Half-life: 6 hrs

Patient Preparation: None

Equipment Used:
Type of Camera or Probe: large field of view gamma with SPECT capability
Collimator used: LEHR, parallel hole

Acquisition Setup:

Dynamic: View(s)
Matrix: 128x128
Time/Frame: 1sec/frame
Number of Frames: 60

Immediate Statics: View(s)
Matrix: 128x128
Total Counts or Duration:750k-1000k counts

SPECT:
Total Rotation: 360
Matrix: 128x128 word mode
Time/Azmuiths: 10sec/stop
Number of Azmuiths: 128

Procedure:
Insert IV into patient. Draw blood, tag with Tc-99 pertechnetate and reinject tagged RBCs. While reinjecting, acquire blood flow images 1 second per frame for 60 seconds. Immediately after the flow, acquire statics for 750k-1000k counts per image. Image views acquired are usually anterior/posterior, anterior/posterior obliques, and right/left laterals. 1-2 hours post injection, acquire delayed images. SPECT is optional for higher resolution.

Normal Uptake and common varients:
Insert an image of a normal scan. Describe the normal uptake, and any normal varients visualized.

external image Untitled.jpg
http://www.ajronline.org/content/143/1/63.full.pdf

A 1 hour delayed blood-pool images, there are increased activity to the defect of sulfur colloid scan. On the posterior view, the hemangioma can be seen.
external image Untitled1.jpg
http://www.ajronline.org/content/143/1/63.full.pdf
Abnormal Uptake:
liver-spleen_scan2.jpg

shows hepatocellular disease

Artifact:

damaged_rbc_went_to_spleen.jpg
This scan shows abnormal uptake into the spleen, this could be a result of the technologist damaging the RBC in the labeling process, which would cause the increased splenic uptake seen, which is an artifact in that it is not an accurate depiction of the patient's response to the test as the RBCs were damaged.







Questions asked in Patient History:
List the common questions asked when taking a patient history for this specific procedure.
  1. Have they had any recent x-ray, CT and MR procedures? Where and when?
  2. Have they had any recent surgeries? What and when?
  3. Is there any problems with the liver?
  4. Are you allergic to any medications?
  5. Have you had any recent trauma? What and when?
  6. Do you have a history of cancer? What type and when?
  7. Have you had any abnormal blood work? What and when?
  8. Are you taking any medications? Please list.
  9. Are you pregnant or breastfeeding?
  10. When was the last time you had anything to eat or drink?
References:

http://interactive.snm.org/docs/pg_ch10_0403.pdf