sodium-pertechnetate-tc-99m and Barrett-Esophagus

The principal radionuclide procedures involved in the evaluation of esophageal disorders that are amenable to surgery are illustrated and briefly described. The role of the radionuclide esophagogram (RE) in the diagnosis and management of achalasia, oculopharyngeal muscular dystrophy and its complications, tracheoesophageal fistulae, pharyngeal and esophageal diverticulae, gastric transposition, and fundoplication is discussed. Detection of columnar-lined esophagus by Tc-99m pertechnetate imaging and of esophageal carcinoma by Ga-67 citrate and Tc-99m glucoheptonate studies also is presented.

Topics: Barrett Esophagus; Deglutition Disorders; Diverticulum, Esophageal; Esophageal Achalasia; Esophageal Diseases; Esophageal Neoplasms; Esophagus; Gallium Radioisotopes; Gastroesophageal Reflux; Humans; Muscular Dystrophies; Organotechnetium Compounds; Radionuclide Imaging; Rhenium; Sodium Pertechnetate Tc 99m; Stomach; Sugar Acids; Technetium; Technetium Tc 99m Sulfur Colloid; Tracheoesophageal Fistula

This study was designed to evaluate the utility of 99mTc pertechnetate esophageal scintigraphy for identifying Barrett's esophagus. Seventeen patients with Barrett's esophagus and seven patients with reflux esophagitis were studied. Eight of 17 patients with Barrett's esophagus had a positive image (sensitivity 47%). In contrast, none of the seven patients with esophagitis had a positive image (specificity 100%). Pentagastrin did not have a significant effect on the sensitivity. There was no correlation between the type of Barrett's epithelium and the sensitivity of the imaging results. However, the test is more frequently positive in those patients with more extensive disease. Our study indicates that technetium pertechnetate imaging should not be used as a screening test for the detection of Barrett's esophagus in patients with symptoms of gastroesophageal reflux, as the negative predictive value of the test is limited.

Topics: Barrett Esophagus; Esophagitis, Peptic; Evaluation Studies as Topic; Humans; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

In 12 patients the endoscopic examination raised the suspicion of Barrett's syndrome. By means of guided biopsies and static scintigraphy with gamma camera and 99m-technetium pertechnetate ectopic gastric mucosa was found in the esophagus of 5 of the patients. In one patient a Barrett's ulcer was found. The establishment of a focus of increased radioactivity proximal from the stomach by static scintigraphy is a proof for the presence of ectopic gastric mucosa in the esophagus. Because of the high risk of malignancy a systemic endoscopic biopsy control is necessary for the patients with proved columnar-cell metaplasia in the esophagus.

Topics: Adult; Barrett Esophagus; Biopsy; Esophagoscopy; Esophagus; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Eight patients who had Barrett's oesophagus confirmed by histology are presented. All had barium swallow examinations and technetium-99m sodium pertechnetate (99Tcm-pertechnetate) scintigraphy, the findings of which are reviewed and discussed. The most valuable diagnostic signs on barium swallow examination related to the site of the stricture and the presence of mucosal outpouchings. Scintigraphy was positive in all eight cases. Patients suspected of having Barrett's oesophagus on barium swallow examination should undergo scintigraphy. When the latter is positive, the endoscopist should be alerted to obtain biopsies not only at the site of stricture but serially as far as the gastrooesophageal junction.

Topics: Aged; Aged, 80 and over; Barium Sulfate; Barrett Esophagus; Esophageal Diseases; Esophagus; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Tc-99m pertechnetate scintigraphy was performed in a patient with Barrett's esophagus and a history of previous lye ingestion. Radionuclide uptake was present in the distal two-thirds of the esophagus and persisted after the drinking of water. This technique is simple and accurate and may be of significant benefit in determining the presence and extent of Barrett's esophagus, which carries an increased incidence of adenocarcinoma development. Examination of patients with chronic gastroesophageal reflux, using this technique, is advocated.

Topics: Barrett Esophagus; Caustics; Child, Preschool; Esophageal Diseases; Esophageal Stenosis; Esophagus; Gastroesophageal Reflux; Humans; Lye; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium

Ten years' experience with pertechnetate (Tc-99m) abdominal scintigraphy has shown that the method is specifically indicated for the diagnosis and location of ectopic gastric mucosa in a Meckel's diverticulum, in enteric or gastric duplications and cysts, and in Barrett's esophagus. Careful patient preparation is essential, and sequential gamma camera imaging for 1 hr in the anterior projection is advisable, with complementary lateral, upright, and postvoiding views. Nonspecific accumulations of the tracer within tumours, intestinal obstructions, arteriovenous malformations, and the urinary tract can be recognized with the help of the clinical history and can be investigated by other tests. This approach has raised the accuracy of the method above 90%.

Topics: Abdomen; Barrett Esophagus; Child, Preschool; Choristoma; Duodenum; Enteritis; Female; Gastric Mucosa; Humans; Jejunum; Male; Meckel Diverticulum; Radionuclide Imaging; Retroperitoneal Space; Sodium Pertechnetate Tc 99m; Technetium; Urinary Bladder; Urinary Bladder Diseases