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Research ArticlePractice Standards

The SNMMI Procedure Standard/ACNM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 3.0

Hung Q. Dam, David C. Brandon, Crystal G. Gantz, Vesper V. Grantham, Chen S. Low, Harry W. Schroeder, Michael G. Stabin and Lionel S. Zuckier
Journal of Nuclear Medicine Technology March 2025, 53 (1) 14-23; DOI: https://doi.org/10.2967/jnmt.124.269004
Hung Q. Dam
1ChristianaCare, Newark, Delaware;
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David C. Brandon
2Emory University, Atlanta, Georgia;
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Crystal G. Gantz
3Newport Hospital, Newport, Rhode Island;
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Vesper V. Grantham
4University of Oklahoma Health Sciences, Oklahoma City, Oklahoma;
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Chen S. Low
5University Hospitals Coventry and Warwickshire, Coventry, England;
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Harry W. Schroeder III
2Emory University, Atlanta, Georgia;
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Michael G. Stabin
6Vanderbilt University, Nashville, Tennessee; and
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Lionel S. Zuckier
7Montifore Medical Center, New York, New York
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Tables

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    TABLE 1.

    Causes of Reduced RBC Labeling Efficiency

    CauseDrug or process
    Complex formation with 99mTcDextrose
    Decreased RBC labelingDigoxin
    Prazosin
    Propranolol
    Formation of RBC antibodiesImmune disorders
    Leukemia and lymphoma
    Methyldopa
    Penicillin
    Prior transfusion or transplantation
    Prior transfusion or transplantationExcess stannous chloride
    Insufficient stannous chloride
    Oxidation or reduction of availability of stannous ionCyclosporin
    Decreased hematocrit
    Heparin
    Hydralazine
    Mechanism unknownCalcium channel blockers
    Dipyridamole
    Doxorubicin
    Iodinated contrast
    Metronidazole
    Quinidine
    Ranitidine
    Sickle-cell disease
    Thalassemia
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    TABLE 2.

    Radiation Dosimetry in Adults for 99mTc-RBCs (135)

    Administered activity (intravenous)Organ receiving largest radiation dose (urinary bladder)Effective dose
    MBqmCimGy/MBqrad/mCimSv/MBqrem/mCi
    555–1,10015–300.0120.0440.00470.017
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    TABLE 3.

    Radiation Dosimetry in Children (5 Years Old) for 99mTc-RBCs (135)

    Administered activity (intravenous)Organ receiving largest radiation dose (urinary bladder)Effective dose
    MBq/kgmCi/kgmGy/MBqrad/mCimSv/MBqrem/mCi
    11.39–26.670.31–0.720.0270.0990.011210.042
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    TABLE 4.

    Dose Estimates to Fetus for 99mTc-RBCs (136)

    Stage of gestationFetal dose
    mGy/MBqrad/mCi
    Early0.00700.030
    3 mo0.00550.020
    6 mo0.00400.015
    9 mo0.00330.012
    • Dose estimates for in vivo or in vitro labeling are only slightly different. The slightly higher values for in vitro labeling are presented here.

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Journal of Nuclear Medicine Technology: 53 (1)
Journal of Nuclear Medicine Technology
Vol. 53, Issue 1
March 1, 2025
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The SNMMI Procedure Standard/ACNM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 3.0
Hung Q. Dam, David C. Brandon, Crystal G. Gantz, Vesper V. Grantham, Chen S. Low, Harry W. Schroeder, Michael G. Stabin, Lionel S. Zuckier
Journal of Nuclear Medicine Technology Mar 2025, 53 (1) 14-23; DOI: 10.2967/jnmt.124.269004

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The SNMMI Procedure Standard/ACNM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 3.0
Hung Q. Dam, David C. Brandon, Crystal G. Gantz, Vesper V. Grantham, Chen S. Low, Harry W. Schroeder, Michael G. Stabin, Lionel S. Zuckier
Journal of Nuclear Medicine Technology Mar 2025, 53 (1) 14-23; DOI: 10.2967/jnmt.124.269004
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  • Article
    • PREAMBLE
    • I. INTRODUCTION
    • II. GOALS
    • III. DEFINITIONS
    • IV. COMMON CLINICAL INDICATIONS
    • V. QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL (IN THE UNITED STATES)
    • VI. PROCEDURE/SPECIFICATIONS OF THE EXAMINATION
    • VII. DOCUMENTATION/REPORTING
    • VIII. EQUIPMENT SPECIFICATION
    • IX. QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION CONCERNS
    • X. RADIATION SAFETY IN IMAGING
    • XI. ACKNOWLEDGMENTS
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    • BIBLIOGRAPHY
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