Improved detection and localization of lower gastrointestinal hemorrhage using subtraction scintigraphy: Clinical evaluation

Currie, Geoffrey M., Towers, Philip A. and Wheat, Janelle M. (2007) Improved detection and localization of lower gastrointestinal hemorrhage using subtraction scintigraphy: Clinical evaluation. Journal of Nuclear Medicine Technology, 35 2: 105-111. doi:10.2967/jnmt.106.037044


Author Currie, Geoffrey M.
Towers, Philip A.
Wheat, Janelle M.
Title Improved detection and localization of lower gastrointestinal hemorrhage using subtraction scintigraphy: Clinical evaluation
Journal name Journal of Nuclear Medicine Technology   Check publisher's open access policy
ISSN 0091-4916
1535-5675
Publication date 2007-06
Sub-type Article (original research)
DOI 10.2967/jnmt.106.037044
Volume 35
Issue 2
Start page 105
End page 111
Total pages 7
Place of publication New York, NY, U.S.A.
Publisher Society of Nuclear Medicine
Language eng
Subject 1103 Clinical Sciences
Formatted abstract
Does subtraction scintigraphy improve the diagnostic utility of scintigraphic evaluation in acute lower gastrointestinal hemorrhage?

Methods
This research was a retrospective clinical study using a repeat-measures design of randomized control and experimental groups. A single patient dataset provided both the control group (conventional scintigraphy) and the experimental group (conventional and subtraction techniques). Forty-nine raw 99mTc-red blood cell studies were randomized and interpreted by 4 independent physicians as conventional scintigraphy data only (round 1). The conventional scintigraphy studies were combined with subtraction images and randomized for reinterpretation (round 2).

Results
Although there was a decrease in the mean, no statistically significant difference was noted between the mean time to bleed detection between interpretive rounds 1 and 2 (P = 0.524). The addition of subtraction scintigraphy to the interpretation process changed the outcome from "probably present" to "absent" for 14% of patients and from "equivocal" to "absent" for another 12%, and this change had a marked effect on the false-positive rate. The false-positive rate decreased from 9.6% in round 1 to 3.6% in round 2. Receiver operator characteristic analysis showed that combining conventional scintigraphy with subtraction scintigraphy improved test performance.

Conclusion
False-positive studies can be reduced by using subtraction scintigraphy in conjunction with conventional scintigraphy in the interpretive process.
COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.
Keyword Bowel hemorrhage
Gastrointestinal tract bleeding
Subtraction scintigraphy
Localization
Lower gastrointestinal hemorrhage
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
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Created: Tue, 16 Mar 2010, 15:50:22 EST by Jon Swabey on behalf of Faculty Of Health Sciences