technetium-tc-99m-sulfur-colloid and Gallbladder-Neoplasms

Massive lower gastrointestinal (GI) bleeding caused by gallbladder carcinoma eroding into the colonic wall was demonstrated accurately by Tc-99m RBCs. In addition, retrograde bleeding into the gallbladder was also identified while arteriography did not show contrast extravasation. This case supports the use of Tc-99m RBCs over Tc-99m sulfur colloid for more accurate localization of lower GI bleeding.

Topics: Acute Disease; Aged; Biliary Fistula; Colonic Diseases; Erythrocytes; Female; Gallbladder Diseases; Gallbladder Neoplasms; Gastrointestinal Hemorrhage; Humans; Intestinal Fistula; Radionuclide Imaging; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Adult; Aged; Cholestasis, Extrahepatic; Colonic Neoplasms; False Positive Reactions; Female; Gallbladder Neoplasms; Humans; Imino Acids; Liver Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Lidofenin; Technetium Tc 99m Sulfur Colloid

In 3,600 patients evaluated with technetium-99m sulfur colloid for metastatic liver disease, 40 had equivocal scans due to a solitary defect in the interior margin of the right lobe. In these patients, the authors differentiated the gallbladder fossa from a metastatic focus using one of two new hepatobiliary agents: technetium-99m labeled pyridoxylideneglutamate and paraisopropylacetanilido iminodiacetic acid. In 31 patients, the focal defect filled with radioactive bile, showing that the solitary defect in the radiocolloid scan was a prominent gallbladder fossa. On laparoscopic biopsy, eight of nine patients whose focal defects were not due to the gallbladder were found to have metastatic disease. The ninth patient had carcinoma of the gallbladder. The need for laparoscopic biopsy was obviated in a majority (78%) of the patients by identifying the gallbladder fossa.

Topics: Adult; Aged; Colloids; Diagnosis, Differential; False Positive Reactions; Gallbladder; Gallbladder Neoplasms; Humans; Liver; Liver Neoplasms; Middle Aged; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid