sodium-pertechnetate-tc-99m and Abdominal-Neoplasms

The authors describe an adult patient with low index of suspicion for polysplenia. The diagnostic contribution of various investigative modalities is considered, and the key role of scintigraphy is specifically highlighted.. CT scan findings revealed multiple abdominal and retroperitoneal masses. Needle biopsy of a flank mass was nonspecific. Tc-99m sulfur colloid liver spleen scintigraphy and Tc-99m heat-denatured RBC scans showed the presence of polysplenia.. Multiple spleens can be mistaken for abdominal neoplasms on CT. Biopsy results may not always be helpful. In patients in whom there is such a diagnostic dilemma, Tc-99m heat-denatured RBC scans can successfully establish the definitive diagnosis of polysplenia.

Topics: Abdominal Neoplasms; Aged; Congenital Abnormalities; Diagnosis, Differential; Erythrocytes; Female; Humans; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Spleen; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Thirteen patients with a history of confirmed liver carcinoma were given either I131 goat polyclonal or murine monoclonal antibodies against alpha-fetoprotein (AFP), and then scanned with a gamma camera. In order to reduce background, nontarget activity, especially in the liver, blood pool, and reticuloendothelial system, 99mTc imaging agents were used for tumor image enhancement by computer-assisted subtraction. A sensitivity of 91% for the primary site, 50% for the lungs (33% for the chest area), and 75% for the abdomen and pelvis was achieved, with a specificity of 100%, 94%, and 100% for these sites, respectively. The accuracy was determined to be 93% for the liver, 86% for the lungs (77% for the chest), and 85% for the abdominal and pelvic area, resulting in an overall accuracy rate for imaging primary and metastatic hepatocellular cancer of 84% (90% if bone metastases are excluded). In two of the 13 patients, lesions that had been missed by conventional liver scintigraphy and transmission computed tomography (CT) were first shown by radioimmunodetection (RAID).

Topics: Abdominal Neoplasms; Adult; alpha-Fetoproteins; Antibodies; Antibodies, Monoclonal; Carcinoma, Hepatocellular; Child, Preschool; Female; Hemangiosarcoma; Humans; Image Enhancement; Image Processing, Computer-Assisted; Liver Neoplasms; Male; Pelvic Neoplasms; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms