Diagnostic Performance of Tc-99m Pertechnetate Scintigraphy for Ectopic Gastric Mucosa in Children: A 12-Year Single-Center Retrospective Study
F Yilmaz, NC Tobar, L Perktas, T Sekmenli, P Karabagli, H Onner, GK GedikBackground:
Ectopic gastric mucosa (EGM) is an important cause of gastrointestinal bleeding in children and may occur most commonly in Meckel’s diverticulum and less frequently in duplication cysts.
Aim:
This study aimed to evaluate the diagnostic performance of Tc-99m pertechnetate scintigraphy for detecting EGM in children in a 12-year single-center cohort.
Methods:
This retrospective study included consecutive pediatric patients who underwent Tc-99m pertechnetate scintigraphy for suspected EGM between 2012 and 2024. Demographic, clinical, imaging, surgical, histopathologic, and follow-up data were reviewed. Histopathology was used as the reference standard when available, whereas clinically negative cases were classified on the basis of follow-up. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated with 95% confidence intervals (CIs).
Results:
A total of 142 children were evaluated. Scintigraphy was positive in 14 patients. Twelve of these underwent surgery and had histopathologically confirmed EGM, including 11 cases of Meckel’s diverticulum and one duplication cyst. The observed sensitivity of Tc-99m pertechnetate scintigraphy was 100% (95% CI: 73.5–100%), specificity was 98.5% (95% CI: 94.6–99.8%), PPV was 85.7% (95% CI: 57.2–98.2%), and NPV was 100% (95% CI: 97.2–100%). Two false-positive cases were identified. No false-negative cases were detected in this cohort.
Conclusion:
Tc-99m pertechnetate scintigraphy appears to be a highly useful and clinically practical method for detecting EGM in children, particularly because of its strong NPV and noninvasive nature. However, diagnostic performance estimates should be interpreted cautiously in view of the retrospective design, limited number of confirmed positive cases, and potential verification bias. Prospective multicenter studies are warranted to further validate these findings.