Splenosis Diagnosis and Imaging Strategies

Splenosis arises from autotransplantation of splenic tissue following trauma or splenectomy, often presenting as asymptomatic nodules scattered through the peritoneal cavity or distant sites. Accurate diagnosis is essential to distinguish these benign implants from malignancies or other pathological masses and to avoid unnecessary interventions. Conventional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) offer morphological clues, yet they can yield indeterminate findings when nodules mimic neoplastic processes. Nuclear medicine techniques exploiting the phagocytic function of splenic macrophages—particularly heat-denatured red blood cell scintigraphy—have long been regarded as the diagnostic gold standard. Recent technological and analytical advances, however, have expanded the toolkit for clinicians and radiologists, improving sensitivity, specificity and the capacity to detect small or ectopic implants. Novel radiotracers, contrast agents and machine-learning algorithms are reshaping both preoperative evaluation and intraoperative localisation, with implications for patient management and global health burden in regions where splenectomy is prevalent.

Research from Nature Portfolio

Recent studies have introduced macrophage-targeted positron emission tomography tracers that bind selectively to reticuloendothelial cells, improving detection of small peritoneal implants. These tracers demonstrate superior spatial resolution compared with conventional scintigraphy and permit quantitative assessment of splenic tissue volume. In parallel, ultra-small superparamagnetic iron oxide nanoparticles have been repurposed as MRI contrast agents, exploiting their uptake by splenic macrophages to generate high-contrast images of heterotopic splenic tissue against surrounding organs. This approach has enabled reliable identification of lesions down to a few millimetres, facilitating non-invasive characterisation without ionising radiation. Additionally, deep-learning frameworks applied to routine CT datasets have shown promise in automating the recognition of splenosis nodules, reducing false positives by distinguishing their texture and vascular patterns from malignant masses. Collectively, these advances integrate molecular specificity with computational power to refine both diagnosis and patient stratification.

Splenosis Diagnosis and Imaging Strategies publication trend

The graph below shows the total number of articles in splenosis diagnosis and imaging strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Splenosis: Heterotopic autotransplantation of splenic tissue following trauma or splenectomy.

Tc-99m heat-denatured red blood cell scintigraphy: Nuclear imaging technique using patient’s heat-damaged erythrocytes labelled with technetium-99m to detect splenic tissue.

68Ga-oxine PET: Positron emission tomography tracer that labels autologous white blood cells or targets macrophages for splenic tissue visualisation.

Ferumoxytol: Iron oxide nanoparticle MRI contrast agent taken up by reticuloendothelial cells, enhancing detection of splenic implants.

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA): Minimally invasive technique combining ultrasound imaging and needle biopsy to sample submucosal or peritoneal lesions.

Indocyanine green fluorescence: Near-infrared dye that accumulates in reticuloendothelial tissue, used intra-operatively to visualise splenic implants under specialised imaging.