Localization of gastrointestinal bleeding using Tc-99m HSA-DTPA SPECT and maximum-intensity projection imaging

When radionuclide imaging is performed using Tc-99m-labeled erythrocytes or human serum albumin, serial planar images are routinely acquired to detect the site of gastrointestinal bleeding. The authors performed Tc-99m DTPA human serum albumin (Tc-99m HSA-DTPA) SPECT scintigraphy in a 61-year-old man with gastrointestinal bleeding. Coronal SPECT and maximum-intensity projection (MIP) images clearly localized the activity in the proximal jejunum, which was obscured on the planar images with an overlap between the activity in the small bowel and the left kidney. A double-contrast barium study of the small intestine revealed a deep ulcer in the proximal jejunum corresponding to the findings of the SPECT images.