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Subtraction Technique for the Detection of Subphrenic Abscesses Using ⁶⁷Ga and ^99mTc

Veterans Administration Hospital, Lexington, Kentucky

Correspondence: For reprints contact: Robert Beihn, Nuclear Medicine Service, Veterans Administration Hospital, Lexington, Ky. 40507.

ABSTRACT

Gallium-67 has been found to localize in inflammatory lesions as well as in liver and spleen. Positive detection of suspected subphrenic abscesses remains a difficult clinical diagnostic problem. The present publication introduces the detection of subphrenic abscesses with ⁶⁷Ga using a modern scanner subtraction technique with ^99mTc.

Patients with clinical symptomatology of a subphrenic abscess and positive correlated roentgenologic findings were scanned at 30 hr following an i.v. injection (35 µCi/kg) of ⁶⁷Ga-citrate. Fifteen minutes prior to the 30-hr scan, 2 mCi of ^99mTc-sulfur colloid and human albumin microspheres were injected intravenously.

A dual 5-in. total-body rectilinear scanner with dual pulse-height analyzer (PHA) subtraction was used in this study. One pulse-height analyzer (A) was energy calibrated for the 184- and 300-keV gamma rays of ⁶⁷Ga. The second pulse-height analyzer (B) was calibrated for the ^99mTc 140-keV gamma ray. When the (B) PHA output was subtracted from the (A) PHA output, a subtraction photoscan resulted. The elimination of liver, spleen, and lung due to the ^99mTc content enhanced the ⁶⁷Ga uptake in subphrenic abscesses.

The results of this preliminary report indicate the usefulness of ⁶⁷Ga and ^99mTc in combination with the subtraction technique as an important aid in the diagnosis of subphrenic abscesses.

FOOTNOTES

^* Present address: Department of Diagnostic Radiology, Univ. of Kentucky Medical Center, Lexington, Ky.

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