What is the role of In-labeled red blood cell (RBC) scintigraphy for evaluation of lower gastrointestinal (GI) bleeding (LGIB)?

Updated: Jul 26, 2019
  • Author: Burt Cagir, MD, FACS; Chief Editor: BS Anand, MD  more...
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Answer

The use of 111In–labeled RBC scintigraphy to detect intermittent bleeding has been described in the medical literature in a few publications. Ferrant and colleagues initially used 111In-labeled RBC scintigraphy in patients with LGIB in 1980, [50] but this technique remains underutilized because of a prolonged half-life of 67 hours. It is also a more expensive and more labor-intensive technology than 99mTc labeling. Furthermore, the image quality and localization of bleeding can be less than desirable because of the prolonged half-life and intestinal motility.

Nonetheless, the longer half-life of 111In-labeled RBC scintigraphy can be useful in locating intermittent bleeding points, particularly when conventional methods have failed. Schmidt et al published a report on six patients in whom 99mTc scanning was initially unrewarding but subsequent scintigraphy with 111In-labeled RBCs located the site of bleeding in all patients. [51] In another study, Mole et al detected synchronous, small and large intestinal adenocarcinomas with 111In-labeled RBC scintigraphy in a 70-year-old patient with intermittent GI bleeding and profound blood loss anemia. [52]


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