Dual isotope scintigraphy in stroke patients

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Abstract
Platelet scintigraphy is a useful technique to detect atherosclerotic lesions of the neck vessels in stroke patients. The habitual one isotope technique causes false positive and false negative results due to circulating platelet-bound activity. To eliminate these confusing results we performed a dual isotope technique on 20 stroke patients. The new method consists of simultaneous injections of 111-Indium labelled blood platelets and 99mTc labelled red cells, and achieves a calculation of the ratio 111-In/ 99mTc. Thus the subtraction of the red cell blood flow image can render a pure thrombus formation visible. The habitual visually evaluated one isotope scintigraphy showed positive scans in 11 out of 20 patients, whereas under dual isotope scintigraphy 3 patients showed no 111-Indium excess after subtraction of the red cell image; they can thus be qualified as false positive. In the case of another patient with a visually negative image a thrombus formation could be observed after the subtraction procedure. It seems, that the dual isotope technique in platelet scintigraphy is a valuable refinement on the way to verifiable results.