Systematic review and meta-analysis comparing the diagnostic utility of Tc-99m tagged RBC scintigraphy with CT-angiography imaging studies in diagnosing lower gastrointestinal bleeding
- Author:
Jose Carlos T. Chanyungco
1
;
Ruben V. Ogbac
1
Author Information
1. Division of Nuclear Medicine, University of the Philippines - Philippine General Hospital
- Publication Type:Journal Article
- Keywords:
Tc99m-tagged RBC scintigraphy;
Red blood cell tagging;
Gastrointestinal bleed scintigraphy;
Lower gastrointestinal bleed
- MeSH:
Computed Tomography Angiography
- From:
The Philippine Journal of Nuclear Medicine
2021;16(2):10-22
- CountryPhilippines
- Language:English
-
Abstract:
Background:Lower Gastrointestinal bleeding (LGIB) is a serious and urgent condition which can be assessed using several
different modalities. Tc-99m tagged RBC scintigraphy has been established as a diagnostic tool in Nuclear
Medicine but several other modalities, including CT-based imaging (i.e. angiography) currently exist.
Objective:The objective of this study is to compare Tc-99m tagged RBC scintigraphy with CT-based imaging studies in
terms of clinical utility and diagnostic outcomes.
Methods:A systematic review of available literature was done, with the goal of creating a meta-analysis focusing on the
reported diagnostic outcomes - mainly sensitivity and specificity on the presence of a LGIB. Aside from this, a
systematic review of the clinical utility and the differences of each test were discussed, including
non-quantifiable advantages. The literature search was conducted following the guidelines of PRISMA, with
searches from PubMed, Medline, and other pertinent databases. Quality assurance was done using the
QUADAS tool. Statistical analyses of sensitivity, specificity, and a summary receiver operating characteristics
plot were computed for the meta-analysis.
Results:Pooled sensitivity and specificity for RBC scintigraphy were 0.886 and 0.119, respectively. Pooled sensitivity and
specificity for CT-based imaging were 0.729 and 0.660, respectively. CT based imaging also showed higher
localization and faster completion times. RBC scintigraphy had a longer acquisition window.
Conclusion:Both Tc99m-tagged RBC scintigraphy and CT-based imaging have important clinical utility, with each modality
having different advantages that the other test cannot provide.
- Full text:Systematic Review.pdf
