Diagnosis and whole body screening using blood pool scintigraphy for evaluating congenital vascular malformations

Background: Because magnetic resonance imaging and angiography are inappropriate for whole-body screening because of high cost or invasiveness, we investigated the potential of whole-body blood pool scintigraphy (WBBPS) as a screening and diagnostic tool for congenital vascular malformations (CVMs). Methods: The subjects of the study were 137 patients (mean age: 20 ± 16 years; range: 0.3-68 years) with suspected CVM. Whole-body anterior and posterior images were acquired twenty minutes after injection of 760 MBq ^99mTc-labeled red blood cells (pediatric dose: 13 MBq/kg). The final diagnosis was determined by clinical findings, magnetic resonance imaging, angiography, Doppler sonography, and lymphoscintigraphy. Results: Of these patients, 124 had venous malformations, and 13 had lymphatic malformations. WBBPS successfully detected abnormal blood pooling lesions in 96.8% (120/124) of the patients with venous malformations. None of the patients with lymphatic malformation showed abnormal uptake on WBBPS. In addition, WBBPS detected 41 additional abnormal vascular lesions that were not found during initial clinical evaluation in 16.9% (21/124) of the patients with venous malformations. Conclusion: WBBPS is a valuable diagnostic and screening modality for the initial evaluation of CVM because of its high characterizing accuracy of 97.1% and the ability to image the whole body.