Clinical Application of Technetium-99m-Labeled Red Blood Cells Subcutaneous Radionuclide Venography and Abdominal/Pelvic Hybrid SPECT/CT Imaging in Patients with Suspicion of Proximal Deep Vein Thrombosis

Technetium-99m-labeled red blood cells subcutaneous radionuclide venography can apply to evaluate deep venous flow of lower extremities. We introduce additional abdominal/pelvic hybrid SPECT/CT (single-photon emission computed tomography with computed tomography) to scrutinize the proximal deep venous flow defects in the iliac vein. SPECT/CT imaging is collected when disturbed or asymmetrical iliac venous flow is noted on the planar imaging of Tc-99m-labeled red blood cells subcutaneous radionuclide venography. The region of SPECT/CT imaging includes abdominal aorta, inferior vena cava and bilateral iliac vessels. We present three cases with suspicion of deep vein thrombosis in the iliac vein. Tc-99m-labeled red blood cells subcutaneous radionuclide venography with SPECT/CT revealed not only provides us the venous flow but also other information including abnormal vessel structure, space-occupying lesion and abnormality in other organs. In conclusion, if disturbed or asymmetrical iliac venous flow and abnormal collateral venous drainage in the abdomen are noted on the Tc-99mlabeled red blood cells subcutaneous radionuclide venography, SPECT/CT imaging may arrange for further information and differential diagnosis of lower extremities swelling; not only in detecting deep vein thrombosis.