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 ((99m)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 (99m)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: (99m)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.