sodium-pertechnetate-tc-99m and Neoplasm-Metastasis

Topics: Adolescent; Adult; Carcinoembryonic Antigen; Child; Diagnosis, Differential; Female; Humans; Iodine Radioisotopes; Male; Neoplasm Metastasis; Radioimmunoassay; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroglobulin; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Thyroid Neoplasms; Thyrotropin; Thyroxine; Time Factors; Triiodothyronine

Accurate staging and early detection of metastases are crucial to melanoma management. It would thus be of great value to have a widely available, cost-effective method that allows to examine the whole body and is more specific than current imaging modalities.. The purpose of the study was to assess the value of immunoscintigraphy with 99mTc-radiolabeled F(ab')2 fragments of the 225.28S monoclonal antibody in the staging of melanoma.. 29 patients with known or suspected metastases were enrolled in the study and examined by monoclonal antibody fragment scintigraphy. The results were compared to physical examination, other imaging modalities and, where available, histology.. Antibody scintigraphy detected 9/34 metastases. There were 2 false-positive lesions. Diagnostic accuracy was 41%, sensitivity 26% and specificity 83%.. 99mTc-radiolabeled F(ab')2 monoclonal antibody-fragment scintigraphy cannot be recommended for staging of melanoma patients. The search for more sensitive radiopharmaceuticals for scintigraphy should thus be encouraged.

Topics: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal; Antibodies, Neoplasm; False Positive Reactions; Female; Humans; Immunoglobulin Fab Fragments; Male; Melanoma; Middle Aged; Neoplasm Metastasis; Predictive Value of Tests; Radioimmunodetection; Sensitivity and Specificity; Skin Neoplasms; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed, Single-Photon

In an effort to identify the site of recurrent colorectal cancer in patients with occult metastasis and increasing serum CEA levels, we conducted two trials using monoclonal antibodies (MoAb) against CEA. The first utilized Indium-111-labeled ZCE-025; an immunoglobulin G1 (IgG1) anticarcinoembryonic antigen (anti-CEA) antibody (Hybritech, San Diego, CA). The second study used Tc-99m-labeled Fab' fragment of IMMU-4 (Immunomedics, Morris Plains, NJ). Eighteen patients were imaged with the ZCE-025 and 14 with the Tc-99m Fab' IMMU-4. True-positive scans, defined as at least one correct correlation of the MoAb scan and surgical/histologic findings, were observed in 12 of 15 patients undergoing exploration or biopsy using the ZCE-025 and 11 of 14 using the IMMU-4. There were no true-negative scans with the ZCE-025 and only 2 of 14 with the IMMU-4. There were 3 false-positive scans with the ZCE-025 and 1 of 14 with IMMU-4. There were no false-negative scans with either ZCE-025 or IMMU-4. Four (31%) of 13 patients undergoing exploration and imaged with ZCE-025 and 5 (36%) of 14 imaged with IMMU-4 had complete tumor resection. Treatment decisions were affected in 3 (16%) of 18 ZCE-025-imaged patients and 3 (21%) of 14 IMMU-4 ones. Two (14%) of 14 patients imaged with IMMU-4 had negative MoAb scans and negative laparotomies. Despite these findings, it is not known whether such early detection and resection will translate into improved survival rates. The authors suggest two randomized studies, one designed to ascertain the role of MoAb added to blind exploratory laparotomy. In that study, patients with increasing CEA levels and a negative workup will be randomized to an exploratory laparotomy preceded by MoAb anti-CEA scans or a straight exploratory laparotomy without the assistance of a MoAb anti-CEA scan. Endpoints will be differences in complete resectability and survival. A second study will examine the merits of blind exploratory laparotomies. In that study, patients with increasing CEA levels and a negative workup would be randomized to MoAb imaging, exploratory laparotomy, and radioimmunoguided surgery, and the other cohort of patients would continue to have conventional radiologic workup. Exploration in this latter group would be performed only when indicated by radiologic or endoscopic studies. The endpoint of the study would compare survival in the two cohorts of patients. These two studies may ultimately settle the debate regarding the correct approach t

Topics: Antibodies, Monoclonal; Carcinoembryonic Antigen; Colonic Neoplasms; Humans; Indium Radioisotopes; Laparotomy; Neoplasm Metastasis; Neoplasm Recurrence, Local; Radioimmunodetection; Rectal Neoplasms; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed, Single-Photon

Developing of algorithm for the post-surgical management of patients with iodine-negative metastasesof differentiated thyroid cancer (DTC).. The DTC patients with iodine-negative metastases (n = 115) were enrolled in the study.Of them the whole body scintigraphy (WBS) was performed with technetium-99m-hexakis-2-methoxyisobutylisonitrile(99mTc-MIBI) (n = 30), WBS with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) (n = 30), 18FDG PET (n = 30), andcomputer tomography (CT-scan) (n = 25). Complex 99mTc-pertechnetate scans including the dynamic and static scintigraphy was performed supplementary to 99mTc-MIBI WBS in 10 patients to obtain the angiographic curves from DTCmetastatic foci. The non-radioiodine radiopharmaceutical technologies, namely the labeled 99mTc-MIBI, 99mTc-DMSA, 99mTc-pertechnetate, and 18FDG were applied to detect the iodine-negative DTC metastases. Radioisotopic examinationswere performed at the dual-head gamma camera (Mediso Medical Imaging Systems Ltd., Hungary) and single photonemission computed tomography (SPECT) scanner «E.CAM» (Siemens, Germany). PET/CT scans were performed on the«Biograph 64 TruePoint» imaging platform (Siemens, Germany) in accordance with the European Association of NuclearMedicine (EANM) recommendations for the Siemens imaging devices with 3D-mode data acquisition.. The conducted research suggested that it is feasible to use the non-radioiodine (99mTc-MIBI and 99mTc-DMSA)radiopharmaceutical technologies to detect the iodine-negative DTC metastases. 18FDG PET is a highly informativetechnology for the detection of iodine-negative DTC metastases in case of lung involvement in the process. Compareof the non-radioiodine radiopharmaceuticals, CT scan and 18FDG-PET/CT indicated the highest sensitivity of 18FDGPET/CT (p < 0.05). WBS with 99mTc-MIBI and 99mTc-DMSA featured the highest specificity (100 %, p < 0.05). X-ray CTis marked by the significantly lower either sensitivity, specificity, and accuracy rate (p > 0.05). Developing andapplication of algorithm for the post-surgical management of patients with iodine-negative forms of DTC will allowfor the betimes detection of relapses and metastases with administration of adequate surgical, radiation, and targeted treatment.. Obtained results offer the opportunity to optimize the post-surgical management of patients withiodine-negative DTC forms using the options of radionuclide diagnostics with non-radioiodine radiopharmaceuticals. The latter are readily available providing the cost-cutting of diagnostic support in these patients. Place ofmorphological methods of diagnosis is determined and stage of monitoring of patients with the iodine-negativemetastases is established. Possibility of the 18FDG-PET tests for the early diagnosis of iodine-negative metastases inDTC for the first time have been studied and substantiated in Ukraine. A comprehensive radiation algorithm for thelong-term monitoring of this category of patients will allow the timely detection of recurrences and metastases ofDTC and appropriate surgery, radiation and targeted therapy administration. Data obtained as a result of the studyallowed to improve the overall and recurrence-free survival rates in the able-bodied DTC patients and reduce thecosts of follow-up of patients with iodine-negative forms of DTC.. Meta: rozrobyty algorytm pisliaoperatsiĭnogo vedennia khvorykh z ĭod-negatyvnymy metastazamy dyferentsiĭovanogo raku shchytopodibnoï zalozy (DRShchZ).Materialy i metody. Grupu doslidzhennia sklaly – 115 khvorykh z ĭod-negatyvnymy metastazamy DRShchZ, z iakykh 30patsiientam bulo provedeno stsyntygrafiiu vs'ogo tila (SVT) z michenym tekhnetsiiem-99 metoksy-izobutyl-izonitrylom (99mTc-MIBI), 30 – SVT z dymerkapto-burshtynovoiu kyslotoiu, michenoiu tekhnetsiiem-99 (99mTc-DMCA), 30 – PET z 18F-FDG, 25 patsiientam bula provedena komp’iuterna tomografiia (KT). Desiaty patsiientam z grupy, v iakiĭ provodyly SVT z 99mTc-MIBI, dodatkovo bulo provedeno kompleksne stsyntygrafichne doslidzhennia z 99mTc-pertekhnetatom,iake vkliuchalo dynamichnu ta statychnu stsyntygrafiï z metoiu oderzhannia angiografichnykh kryvykh z metastatychnykhvognyshch DRShchZ. Dlia diagnostyky ĭod-negatyvnykh metastaziv DRShchZ zastosovuvaly metodyky z vykorystanniamneĭodnykh radiofarmpreparativ (RFP), a same: micheni 99mTc-MIBI, 99mTc-DMCA, 99mTc-pertekhnetat i 18F-FDG. Radionuklidni doslidzhennia vykonuvaly na dvodetektorniĭ gamma-kameri firmy «Mediso» (Ugorshchyna) ta odnofotonnomu emisiĭnomu komp’iuternomu tomografi (OFEKT) «E. CAM 180» firmy «Siemens» (Nimechchyna). PET/KT provodyly na kombinovanomu tomografi «Biograph-64-TruePoint-Siemens» (Nimechchyna), zgidno z rekomendatsiieiu Ievropeĭs'koï Asotsiatsiï iadernoï medytsyny (EANM) dlia aparativ vyrobnytstva «Siemens» z 3D-rezhymom zbyranniainformatsiï.Rezul'taty. Provedeni doslidzhennia pidtverdyly mozhlyvist' vykorystannia metodyk z neĭodnymy RFP (99mTc-MIBI, 99mTc-DMCA) dlia vyiavlennia ĭod-negatyvnykh metastaziv DRShchZ. PET/KT z 18F-FDG ie vysokoinformatyvnoiu metodykoiu vyiavlennia ĭod-negatyvnykh metastaziv DRShchZ pry prolongatsiï protsesu v legeni. Porivnial'na otsinka neĭodnykhRFP, KT ta PET/KT z 18F-FDG vyiavyla, shcho naĭvyshchyĭ pokaznyk chutlyvosti kharakternyĭ dlia PET z 18F-FDG (r < 0,05).Spetsyfichnist' naĭbil'sh vysoka (100 %) pry SVT z 99mTc-MIBI i 99mTc-DMSA (r < 0,05). Rentgenivs'ka KT kharakteryzuiet'sia dostovirno nyzhchymy pokaznykamy iak chutlyvosti, tak i spetsyfichnosti ta tochnosti (r > 0,05). Stvorennia ivykorystannia algorytmu pisliaoperatsiĭnogo vedennia khvorykh z ĭod-negatyvnymy formamy DRShchZ dozvolyt' vchasno vyiavliaty retsydyvy ta metastazy i provodyty vidpovidne likuvannia, a same khirurgichne, promeneve ta targetne.Vysnovky. Oderzhani rezul'taty dozvolyly optymizuvaty pisliaoperatsiĭne vedennia pats

Topics: Algorithms; Fluorodeoxyglucose F18; Humans; Iodine Radioisotopes; Neoplasm Metastasis; Neoplasm Recurrence, Local; Organotechnetium Compounds; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Survival Analysis; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Gland; Thyroid Neoplasms; Ukraine; Whole-Body Counting

The purpose of this study is to assess the role of whole-body (WB) DWI as a screening modality for the detection of metastases and to compare it to conventional cross-sectional imaging modalities or nuclear scintigraphy in a population with various histopathologic malignancies.. WB DWI and conventional imaging (CT, MRI, or scintigraphy) were performed for patients with known malignancies for metastatic workup, and these patients were followed up for a period of 1 year. Two radiologists assessed WB DW images separately, and conventional images were assessed by the senior radiologist. The metastatic lesions were classified into four regions: liver, lung, skeletal system, and lymph nodes. The reference standard was considered on the basis of histopathologic confirmation or clinical follow-up of the metastatic lesions.. WB DWI was slightly inferior to conventional imaging modalities for the detection of hepatic metastases (sensitivity, 86.6% vs 93.3%; specificity, 91.6% vs 95.8%; and accuracy, 89.7% vs 94.8%) and skeletal metastases (sensitivity, 81.8% vs 89.4%; specificity, 86.4% vs 94.3%; and accuracy, 85.2% vs 93.0%); however, the differences were not statistically significant (p = 0.625 for hepatic metastases and p = 0.0953 for skeletal metastases, McNemar test). WB DWI was statistically significantly inferior to conventional imaging for the detection of lymph node metastases (sensitivity, 74.0% vs 81.5%; specificity, 87.9% vs 90.1%; accuracy, 81.4% vs 86.0%; p = 0.0389). WB DWI was statistically significantly inferior to conventional imaging for the detection of pulmonary metastases (sensitivity, 33.3% vs 100.0%; specificity, 90.9% vs 100.0%; accuracy, 60.8% vs 100.0%; p = 0.045).. WB DWI can be used for screening hepatic and skeletal metastases, but its reliability as the sole imaging sequence for the detection of lymph nodal and pulmonary metastases is poor and, at present, it cannot replace conventional imaging modalities.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Contrast Media; Diffusion Magnetic Resonance Imaging; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Tomography, X-Ray Computed; Whole Body Imaging

Imaging spontaneous cancer cell metastasis or heterogeneous tumor responses to drug treatment in vivo is difficult to achieve. The goal was to develop a new highly sensitive and reliable preclinical longitudinal in vivo imaging model for this purpose, thereby facilitating discovery and validation of anticancer therapies or molecular imaging agents.. The strategy is based on breast cancer cells stably expressing the human sodium iodide symporter (NIS) fused to a red fluorescent protein, thereby permitting radionuclide and fluorescence imaging. Using whole-body nano-SPECT/CT with (99m)TcO4(-), we followed primary tumor growth and spontaneous metastasis in the presence or absence of etoposide treatment. NIS imaging was used to classify organs as small as individual lymph nodes (LNs) to be positive or negative for metastasis, and results were confirmed by confocal fluorescence microscopy. Etoposide treatment efficacy was proven by ex vivo anticaspase 3 staining and fluorescence microscopy.. In this preclinical model, we found that the NIS imaging strategy outperformed state-of-the-art (18)F-FDG imaging in its ability to detect small tumors (18.5-fold-better tumor-to-blood ratio) and metastases (LN, 3.6-fold) because of improved contrast in organs close to metastatic sites (12- and 8.5-fold-lower standardized uptake value in the heart and kidney, respectively). We applied the model to assess the treatment response to the neoadjuvant etoposide and found a consistent and reliable improvement in spontaneous metastasis detection. Importantly, we also found that tumor cells in different microenvironments responded in a heterogeneous manner to etoposide treatment, which could be determined only by the NIS-based strategy and not by (18)F-FDG imaging.. We developed a new strategy for preclinical longitudinal in vivo cancer cell tracking with greater sensitivity and reliability than (18)F-FDG PET and applied it to track spontaneous and distant metastasis in the presence or absence of genotoxic stress therapy. Importantly, the model provides sufficient sensitivity and dynamic range to permit the reliable assessment of heterogeneous treatment responses in various microenvironments.

Topics: Adenocarcinoma; Antineoplastic Agents, Phytogenic; Breast Neoplasms; Cell Line, Tumor; DNA Damage; Environment; Etoposide; Female; Fluorescence; Humans; Lymph Nodes; Microscopy, Confocal; Neoadjuvant Therapy; Neoplasm Metastasis; Neoplasms; Positron-Emission Tomography; Radiopharmaceuticals; Reproducibility of Results; Sodium Pertechnetate Tc 99m; Symporters; Tissue Distribution; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Whole Body Imaging

The aim of the study was to evaluate the usefulness of (99m)Tc-pertechnetate whole body scan (WBS) with neck and chest SPECT/CT for detection of post-surgical thyroid remnant and metastasis in differentiated thyroid cancer (DTC) patients.. Fifty-six post total thyroidectomy patients were included. All patients were prospectively imaged with (99m)Tc-pertechnetate WBS with neck and chest SPECT/CT before (131)I ablation. The post-ablative (131)I WBS with SPECT/CT was performed at 5-7 days after receiving (131)I. Both scans were directly compared to determine the concordance of sites and number of remnant and metastasis.. Overall per-patient analysis, the percentage of concordance between two scans was 96.4%. In thyroid bed, lymph node, lung and bone subgroups, the percentage of concordance between two scans was 96.4, 92.9, 98.2 and 100%, respectively. All of them show good correlation with unweighted kappa between 0.7 and 1. Overall per-lesion analysis, the percentage of concordance between two scans was 84%. In thyroid bed, lymph node, lung and bone subgroups, the percentage of concordance between two scans was 89.5, 55, 82.6 and 50%, respectively.. Pre-ablative pertechnetate WBS with neck and chest SPECT/CT has good correlation for the detection of post-surgical thyroid remnant, cervical node and discrete lung nodule metastasis as compared to (131)I WBS with SPECT/CT per-patient basis. Because (131)I therapeutic activity is desired base on metastatic site and less concerning about the number of lesions, pre-ablative (99m)Tc-pertechnetate WBS with SPECT/CT was a good alternative tool to avoid radioiodine stunning in post-surgical DTC patients.

Topics: Adult; Aged; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Multimodal Imaging; Neck; Neoplasm Metastasis; Postoperative Period; Radiography, Thoracic; Sodium Pertechnetate Tc 99m; Thorax; Thyroid Gland; Thyroid Neoplasms; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Whole Body Imaging; Young Adult

99mTc pertechnetate is considered insensitive in detecting thyroid carcinoma metastases. We report the case of a 71-year-old male patient, in whom metastasis of an unknown thyroid cancer was diagnosed incidentally on a routine 99mTc pertechnetate scan, performed for the assessment of nodular thyroid disease. Marked tracer accumulation was unexpectedly noted on the left frontal region, where a palpable, painless, soft tissue mass was present. Surgical excision of the mass revealed metastatic poorly differentiated thyroid carcinoma synchronous to soft tissue and adjacent bone.

Topics: Aged; Humans; Incidental Findings; Male; Neoplasm Metastasis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Gland; Thyroid Neoplasms

Three cases of imaging with 99mTc-pertechnetate (99mTcO4) and unusual positive lymph node uptake in the neck are reported hereby. Two cases were later diagnosed to be well-differentiated thyroid carcinoma, (DTC) with nodal metastasis. The third was a confirmed case of carcinoma thyroid that had presented with mass in the neck soon after surgery, being prepared for ablative dose of radioactive iodine (131I). All three were young females under 40 years of age. These 3 cases signify that extra thyroidal areas of uptake on a routine thyroid scan with 99mTcO4 can some time be due to thyroid carcinoma with regional metastases. Foci of metastasis in patients with DTC may be incidentlly detected with 99mTcO4 scan. Multinodular goiter with palpable lymph node should always be investigated for exclusion of malignancy. The patients underwent near total thyroidectomy and radical neck dissection; histopathology confirmed the scan findings.

Topics: Adult; Female; Humans; Immunohistochemistry; Lymphoma, Non-Hodgkin; Neoplasm Metastasis; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Thyroid Function Tests; Thyroid Neoplasms; Thyroidectomy; Tomography, Emission-Computed; Treatment Outcome; Ultrasonography

Preoperative scintigraphic visualization of metastases from well-differentiated thyroid microcarcinoma in patients with Graves disease is extremely rare, as is the scintigraphic visualization of poorly differentiated thyroid carcinoma as a warm nodule. We present a patient with Graves disease and both of these rare entities.. A 47-year-old woman complained of a growing left-side neck mass and symptoms of thyrotoxicosis. On clinical examination, the thyroid was palpable without discernible nodularity, while the left side of the neck was occupied by 3 gross, painless nodules. She also had signs of thyrotoxicosis and biochemical parameters of Graves hyperthyroidism. Ultrasound examination showed moderately hypoechogenic thyroid with a small hypoechogenic nodule in the upper pole of the left lobe and 3 gross, almost normoechogenic nodules on the left side of the neck. On Tc-99m-pertechnetate pinhole scintigraphy there was a small, warm nodule in the upper pole of the left lobe and 3 gross metastatic nodules on the left side of the neck. Fine needle aspiration of the neck nodules was consistent with metastases from thyroid papillary carcinoma. After thyrostatic preparation a total thyroidectomy with left modified radical neck dissection was done.. Histopathologic examination disclosed 2 carcinomas in the left thyroid lobe. One of them was a tall cell variant of papillary carcinoma in the upper pole of the left lobe that measured 5 mm and corresponded to the small warm nodule, and the second one was a classic form of papillary microcarcinoma that measured 2 mm. Metastases accrued from the classic form of papillary microcarcinoma. Although the patient had 2 thyroid carcinomas, one with metastases and the other of more aggressive form, which is consistent with advanced stage and aggressiveness, she is now disease-free, 4 years after the operation and radioiodine ablation.

Topics: Carcinoma, Papillary; Female; Graves Disease; Head and Neck Neoplasms; Humans; Middle Aged; Neoplasm Metastasis; Preoperative Period; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Neoplasms

To determine outcome for dogs with nonresectable thyroid carcinomas treated with sodium iodide I 131 and identify factors associated with outcome.. Retrospective case series. Animals-39 dogs.. A definitive or presumptive diagnosis of thyroid tumor was made on the basis of cytologic or histologic examination, abnormal accumulation of sodium pertechnetate Tc 99m during scintigraphy, or both, and dogs were treated with sodium iodide I 131. Dogs with cervical thyroid tumors were evaluated 3 to 6 weeks after 131I therapy, and residual tumor was resected when feasible.. Prior to 131I therapy, 32 dogs had a solitary mass and 7 had metastases; 21 were hyperthyroid, 16 were euthyroid, and 2 were hypothyroid. Median survival time for dogs with local or regional tumors (ie, stage II or III) was significantly longer (839 days) than median survival time for dogs with metastasis (366 days). Tumor site (cervical vs ectopic), dose of sodium iodide I 131, age, body weight, treatment (131I therapy alone vs 131I therapy followed by surgery), and serum T4 concentration prior to 131I therapy were not significantly associated with survival time. Three dogs died of radioiodine-associated myelosuppression within 3 months after treatment, but no specific factor associated with development of toxicosis was identified.. Results suggested that 131I therapy may result in prolonged survival times in dogs with nonresectable thyroid tumors, regardless of serum thyroxine concentration prior to treatment. Dogs undergoing 131I therapy should be monitored for signs of bone marrow suppression.

Topics: Animals; Dog Diseases; Dogs; Female; Iodine Radioisotopes; Male; Neoplasm Metastasis; Radionuclide Imaging; Retrospective Studies; Sodium Pertechnetate Tc 99m; Survival Analysis; Thyroid Neoplasms; Thyroxine; Treatment Outcome

The aim of this study was to determine the prevalence of trapping-only nodules of the thyroid gland. The study was prospectively performed in patients bearing hot or warm thyroid nodules at pertechnetate scan in the presence of circulating thyrotropin (TSH) within the normal range. The study was restricted to these patients because nodules that suppress TSH are certainly autonomous. In 140 patients showing hot or warm nodules at 30-minute pertechnetate scintigraphy, and normal TSH levels, radioiodine scintigraphy was performed at 24 hours. The trapping-only pattern, i.e., the presence of a cold nodule in late radioiodine scintigraphy was observed in seven patients (5%). Five had benign thyroid nodules, one follicular carcinoma, and one extrathyroid metastases of papillary-follicular carcinoma. Despite controversy on this issue, trapping-only nodules of thyroid should be searched because they have risk of malignancy and must be differentiated from autonomous adenomas at the compensated stage. The search may be limited to patients with normal serum TSH.

Topics: Adenocarcinoma, Follicular; Adult; Aged; Carcinoma; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Neoplasm Metastasis; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Thyroid Neoplasms; Thyroid Nodule; Thyrotropin

Poorly differentiated insular thyroid carcinoma is classified as a separate entity among other tumors of the thyroid gland. Its histological pattern and clinical course are regarded as intermediate between well-differentiated and anaplastic thyroid cancer. The authors report Tc-99m pertechnetate, Tc-99m MDP and radioiodine imaging features in a 33-year-old male patient with metastatic insular carcinoma of the thyroid. The extent of involvement was almost identical in all three studies. Insular carcinoma of the thyroid was shown by biopsy, and the patient received a cumulative dose of 14,800 MBq (400 mCi) radioactive I-131. Other radionuclide imaging agents are also reviewed.

Topics: Adult; Humans; Iodine Radioisotopes; Male; Neoplasm Metastasis; Palliative Care; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Medronate; Thyroid Neoplasms; Treatment Outcome

The anti-carcinoembryonic antigen (CEA) antibody, BW 431/26 (Scintimun CEA, Behringwerke, Marburg, Germany ) labeled with technetium pertechnectate (99mTc), is an intact immunoglobulin G1, monoclonal antibody that has been used to image colorectal cancer. Planar and SPECT images of chest, abdomen and pelvis were performed at 10 minutes, 4-6 and 18-24 hours after the intravenous antibody injection. 44 patients were studied and the pathological antibody concentration localization by radioimmunoimaging (RI) were correlated with surgical, clinical and other imaging modality findings to validate the RI. The RI was positive in 29 patients and negative in the other 15 patients. The CEA and CA 19.9 were elevated in the serum of some patients with primary tumors or recurrence. The HAMA were determined in all the patients before and after the RI.

Topics: Adult; Aged; Animals; Antibodies, Monoclonal; Antigens, Neoplasm; CA-19-9 Antigen; Carcinoembryonic Antigen; Carcinoma; Colonic Neoplasms; Colorectal Neoplasms; Evaluation Studies as Topic; Female; Humans; Male; Mice; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasm, Residual; Predictive Value of Tests; Radioimmunodetection; Rectal Neoplasms; Sigmoid Neoplasms; Sodium Pertechnetate Tc 99m; Species Specificity; Tomography, Emission-Computed, Single-Photon

Topics: Adenocarcinoma, Follicular; Aged; Female; Gastric Mucosa; Humans; Iodine Radioisotopes; Neoplasm Metastasis; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Thyroid Neoplasms

Sixty-four patients operated for colorectal cancer comprise the study group. CEA and CA-19.9 markers were used. The antibodies were labelled with 131I, using for the scintigraphy 99mTc as well. Eighty eight metastatic foci were detected, 67 of them (76.1 per cent) confirmed by the surgeon: Of 55 pelvic localizations, surgically detected were 47 (85.5 per cent), of 24 in the abdominal cavity 15 (62.5 per cent) were confirmed and of 9 in the liver--only 5 (55 per cent). Radioimmunoassay more accurate in pelvic localizations, whereas echography and computer tomography were more precise in liver examination (83.3 per cent).

Topics: Adult; Aged; Antibodies, Monoclonal; Antigens, Tumor-Associated, Carbohydrate; Carcinoembryonic Antigen; Colorectal Neoplasms; Humans; Iodine Radioisotopes; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Sodium Pertechnetate Tc 99m

Over 3 years, a prospective comparison was made between Tc-99m pertechnetate and I-131 for the detection of residual and metastatic tissue in the follow-up of patients with cancer of the thyroid. All patients stopped thyroid medication for a minimum of 4 weeks. All patients had imaging done first with Tc-99m pertechnetate followed within a maximum of 2 weeks by I-131. The study included 66 patients in whom 81 studies were done with both Tc-99m and I-131. The results showed that 27 studies were positive with both Tc-99m and I-131 (true positive): 19 in the thyroid bed, four lymph nodes, two bony metastases, and two pulmonary metastases. Five patients had negative results with Tc-99m and positive results with I-131 (false negative): three in the thyroid bed, one lymph node metastasis, and one pulmonary metastasis. Only one case was positive with Tc-99m in the neck but negative with I-131 (false positive). The remaining 48 studies were negative both with Tc-99m and I-131 (true negative). Considering I-131 imaging as the standard procedure, Tc-99m had a sensitivity of 87%, specificity of 97%, and accuracy of 92.5% for the detection of residual or metastatic functioning thyroid tissue.

Topics: Adenocarcinoma; Carcinoma, Papillary; Humans; Iodine Radioisotopes; Neoplasm Metastasis; Neoplasm Recurrence, Local; Prospective Studies; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Neoplasms

Topics: Humans; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Neoplasms

Topics: Adolescent; Adult; alpha-Fetoproteins; Antibodies, Neoplasm; Carcinoembryonic Antigen; Female; Humans; Iodine Radioisotopes; Isotope Labeling; Male; Neoplasm Metastasis; Neoplasms; Radionuclide Imaging; Serum Albumin; Sodium Pertechnetate Tc 99m; Subtraction Technique; Technetium; Technetium Tc 99m Aggregated Albumin; Thyroglobulin

A dual radionuclide subtraction technique for external detection of tumours has been evaluated to determine the viability of the method for use with radioisotope labelled antibodies. A number of external scintigraphic investigations have been carried out with 131I-labelled antibodies to carcinoembryonic antigen (CEA). The investigations were performed on patients with metastatic disease known to produce CEA. The dual radionuclide subtraction technique was used to account for the blood and tissue background. The 131I-labelled antibodies were found to localise in the metastatic lesions, but the subtraction technique using 99Tcm-labelled HSA and pertechnetate gave ambiguous results, which included the production of artefacts. The ambiguities noted in the clinical results were substantiated by experimental data, which highlight the unreliability of this technique.

Topics: Antibodies, Neoplasm; Carcinoembryonic Antigen; Female; Humans; Iodine Radioisotopes; Neoplasm Metastasis; Neoplasms; Radionuclide Imaging; Serum Albumin; Sodium Pertechnetate Tc 99m; Subtraction Technique; Technetium; Technetium Tc 99m Aggregated Albumin

The intensity of parenchymal brain lesions was compared using Tc-99m pertechnetate and Tc-99m phosphate. The following conclusions were made: 1. If the Tc-99m phosphate intensity is greater than the intensity of the Tc-99m pertechnetate scan, and the patient is evaluated within four weeks of ictus, the lesion is a CVA (P less than .001). 2. If the Tc-99m phosphate intensity is less than or equal to the intensity of the Tc-99m pertechnetate scan, and the patient is evaluated within four weeks of ictus, the parenchymal lesion is not a CVA (P less than .001). 3. If the evaluation takes place longer than six weeks after ictus, then no evaluation about the nature of the lesion can be made based upon uptake of Tc-99m phosphate and Tc-99m pertechnetate.

Topics: Adult; Brain Neoplasms; Diphosphonates; Glioblastoma; Glioma; Humans; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed