Preoperative Diagnosis of Orbital Cavernous Hemangioma: A 99mTc-RBC SPECT Study

PURPOSE: This study aimed to describe Tc-labeled RBC scintigraphy as a diagnostic method for orbital cavernous hemangiomas and to evaluate this diagnostic tool according to surgical outcomes. METHODS: Fifty-five patients with clinical and radiological (US, CT, and/or MRI) suspicion of unilateral cavernous hemangioma of the orbit underwent Tc-RBC SPECT study.Qualitative and semiquantitative evaluations were performed, and results were statistically analyzed. RESULTS: SPECT images showed focal uptake in the orbital mass in 36 of 55 patients. Nineteen patients had a negative scintigraphic pattern, with concordance of early and late absence of uptake of Tc-RBC.Our procedure showed 100% sensitivity and 88.9% specificity for the diagnosis of orbital cavernous hemangioma, with a positive predictive value of 90.9% and a negative predictive value of 100%. CONCLUSIONS: Tc-RBC imaging is safe, easy to perform, and highly accurate in providing adequate clinical and surgical management. As a noninvasive and highly specific method for diagnosing orbital hemangioma, Tc-RBC scintigraphy can avoid more invasive imaging or biopsy