The application of technetium-99m-red blood cell scintigraphy in the diagnosis of orbital cavernous hemangioma

OBJECTIVE The purpose of this study was to evaluate the clinical value of technetium-99m-red blood cell (Tc-RBC) scintigraphy in the diagnosis of orbital cavernous hemangioma (OCH). PATIENTS AND METHODS Forty-one patients with pathologically confirmed orbital mass, of which 10 were OCH, underwent Tc-RBC scintigraphy in this study. The scanning procedure included an initial perfusion phase, followed by an early and a delayed blood pool phase. All patients underwent ultrasonography and computed tomography (CT), and 15 patients also underwent MRI. RESULTS All 10 OCH patients had no abnormal findings on radionuclide angiographic images and early blood pool phase, but increased activity was found during delayed blood pool phase. All other non-OCH orbital tumours did not have this tracer pattern. The radioactivity ratios of tumour to nontumour were 2.96±0.05 and 1.14±0.25, respectively, which had a statistically significant difference (t=15.18, P<0.001). Although nine of 10 OCH patients were diagnosed correctly with one false-positive case using ultrasound, both CT and MRI could not provide a definitive diagnosis. CONCLUSION Tc-RBC scintigraphy is a reliable and useful procedure for the diagnosis of OCH. It may be considered as one of the routine clinical screening tools for the diagnosis of OCH and as a complement investigation to ultrasonography and CT.