Pitfall to Modified In Vivo Method of Technetium-99m Red Blood Cell Labeling

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Abstract
Suboptimal labeling of red blood cells [RBC] with 99mTc, using the modified in vivo technique, was observed in 3 patients in whom labeling was attempted following i.v. administration of iodinated contrast media in the previous 24 h. The mechanism is not understood, but it may represent a change in either stannous ion distribution or redox potential. Evidently, studies employing 99mTc RBC labeling using this technique be performed prior to administration of iodinated contrast media. This effect should be kept in mind in gastrointestinal bleeding studies performed using 99mTc RBC, as well as in cardiac imaging studies.