Relevance of biophysical concepts in the scintigraphic detection of gastrointestinal leaks

The application of some physical concepts is described to explain the inherent insensitivity of 99Tc(m)-red blood cell (RBC) and 99Tc(m)-human serum albumin (HSA) in the detection of gastrointestinal bleeding and protein-losing enteropathy (PLE), respectively. Inferences drawn from the laws of radioactive decay, partition physics, hydrodynamics and electrostatic forces have been used to suggest that the clearance pattern, size and charge of radiopharmaceuticals, and the viscosity of the medium, affect the sensitivity of these tests. As the outflow from gastrointestinal lesions is non-specific, other labelled macromolecules can be used instead of RBCs or HSA. Based on biophysical concepts, we suggest that chargeless macromolecules in the size range 5-50 nm are superior to the conventional agents used for this purpose.