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This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Ehsan, S.R. Articles by Halkar, R. PubMed Articles by Ehsan, S.R. Articles by Halkar, R.

Optimizing hepatobiliary scan for diagnosis of acute cholecysitis

¹ Nuclear Medicine, Emory University Hospital, Atlanta, Georgia

1047

Objectives: Hepatobiliary scan for acute cholecystitis by SNM guidelines is acquired for 40-60 minutes, with added 30 minutes if morphine augmentation is needed. Due to rising health care costs, we aim to optimize hepatobiliary scan by imaging the initial and the last 5 minutes of a 60 minute study to increase camera and technologist's time for other studies.

Methods: This retrospective study included 30 consecutive patients(M:F::13:17,22-94 yrs),who had a hepatobiliary scan for suspected acute cholecystitis according to SNM guidelines using Choletec. Of these,5 had been diagnosed with cystic duct obstruction after receiving morphine. Initial and latter 5 minutes of the dynamic studies were reformatted for display.Both sets were reviewed by two nuclear medicine physicians for concordance on need of morphine augmentation.A third physician decided where a difference of opinion occurred.Their findings were compared to the final results.

Results: Viewing initial and last 5 minute frames of dynamic studies, and basing their judgment on gallbladder visualization, the two physicians concurred on 29 studies to either proceed with morphine augmentation or not.These findings reconciled with the final reports. In the remaining case, one physician wanted to proceed and the other was undecided on morphine augmentation.Visualization of the duodenal bulb might have been the source of confusion. The study was reviewed by a third physician who recommended morphine,which concurred with the final report.

Conclusions: Hepatobiliary scan, in evaluation of acute cholecystitis can be optimized by imaging initial and last 5 minutes of a 60 minute dynamic study with additional views and morphine augmentation decided upon subsequently. The significance of the proposed method will reduce camera time by almost 45 minutes and increase nuclear medicine resources for other studies.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Ehsan, S.R. Articles by Halkar, R. PubMed Articles by Ehsan, S.R. Articles by Halkar, R.