sodium-pertechnetate-tc-99m and Soft-Tissue-Neoplasms

A 43-year-old woman with papillary thyroid cancer prepared for I ablation after total thyroidectomy. With a history of type 2 diabetes for 10 years, she recently presented with periodontitis, candidiasis, and mouth dryness. TcO4 scintigraphy was ordered to evaluate function of the salivary glands. The scintigraphy incidentally found a focal TcO4 uptake in the left supraclavicular region. The subsequent neck ultrasonography showed a hypoechoic soft tissue mass with heterogeneous hypervascularity, suggestive of hemangioma.

Topics: Adult; Biological Transport; Carcinoma, Papillary; Female; Hemangioma; Humans; Incidental Findings; Radionuclide Imaging; Salivary Glands; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Thyroid Cancer, Papillary; Thyroid Neoplasms; Thyroidectomy

Although carcinoma is rarely metastatic to the thyroid gland, it has an established place in the differential diagnosis of cold nodules on radionuclide thyroid scans in patients with known cancers. A case of metastatic pleomorphic liposarcoma with involvement of the thyroid gland adds to the list of cases of metastases to the thyroid gland. A patient with known metastatic pleomorphic liposarcoma with a palpable thyroid nodule of 2 months' duration had a thyroid scan with 130 MBq (3.5 mCi) Tc-99m pertechnetate. The scan showed a cold nodule occupying most of the right lobe of the thyroid. Cytologic analysis of a fine-needle aspirate from this cold nodule confirmed metastasis from the known primary cancer, pleomorphic liposarcoma. In a patient with a known primary tumor, a nodule in the thyroid gland should be considered a metastatic lesion, regardless of the time since the primary tumor was diagnosed and treated, until proved otherwise.

Topics: Biopsy; Bone Neoplasms; Female; Follow-Up Studies; Humans; Liposarcoma; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Thigh; Thyroid Neoplasms

Tc-99m pertechnetate scintigraphy was compared with Tl-201 chloride and Ga-67 citrate to evaluate the avidity of Tc-99m pertechtate for malignant soft-tissue tumors. Twenty-three patients with malignant soft-tissue tumors underwent scintigraphic studies. All 23 received Tc-99m and Tl-201, whereas 14 also were injected with Ga-67. In 21 (91%) of the 23 patients, Tc-99m accumulated extensively in the tumors. Tl-201 accumulated in 12 (52%) of the 23 tumors. Ga-67 accumulated in only 5 (36%) of the 14 tumors. The avidity of Tc-99m for myxoid tumors was markedly different from the other two agents. Tc-99m accumulated in all eight myxoid tumors, while neither Tl-201 or Ga-67 showed marked accumulation except for one patient with increased accumulation of Tl-201. This study shows that Tc-99m pertechnetate has the potential to localize malignant soft-tissue tumors and may be useful in the evaluation of these tumors.

Topics: Extremities; Female; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Liposarcoma; Male; Middle Aged; Radionuclide Imaging; Retrospective Studies; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Thallium Radioisotopes

We investigated the usefulness of whole-body imaging as an adjunct to spot imaging in soft-tissue vascular lesions, such as hemangiomas and vascular malformations. Spot imaging of the known lesion and whole-body imaging were performed 1-3 hours after the injection of Tc-99m RBC in 42 patients with soft-tissue vascular lesions. Whole-body imaging was considered to be useful in only two patients, who had multiple distant occult lesions in addition to large known lesions. It was suggested that the routine addition of whole-body imaging is not cost effective in patients with soft-tissue vascular lesions, although it may be beneficial for detecting occult lesions in patients with hemangiomas.

Topics: Adolescent; Adult; Aged; Blood Vessels; Child; Child, Preschool; Cost-Benefit Analysis; Erythrocytes; Female; Hemangioma; Humans; Male; Middle Aged; Neoplasms, Unknown Primary; Neoplasms, Vascular Tissue; Radionuclide Angiography; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Whole-Body Counting

The purpose of this study was to investigate technetium-99m pertechnetate (Tc-99m) as a tumor-scanning agent in patients with extra-abdominal fibromatosis, and to establish the sensitivity of this type of scintigraphy. Eleven patients with extra-abdominal fibromatosis were studied: all but one having postsurgical recurrences. Of the 11 patients, diagnosed histologically, 5 underwent repeated Tc-99m scintigraphic follow-up examinations. The injected 370 MBq Tc-99m gave us an early scintigram within 10 min and a delayed one 2 h later. For adequate comparison, the region of interest (ROI) of the scintigram was placed over the tumor. The tumor-to-background (T/BG) count ratio was computed. Extra-abdominal fibromatoses, even recurrences, were demonstrated scintigraphically in both the early and the delayed phase, in all 11 patients. The average T/BG ratio was 2.11 in the early scintigram and 2.15 in the delayed one. The sensitivity and the specificity were both 100%. Tc-99m scintigraphy has proved useful in detecting extra-abdominal fibromatoses and in the follow-up of patients.

Topics: Adult; Female; Fibroma; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Neoplasm Recurrence, Local; Predictive Value of Tests; Radionuclide Imaging; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms

The purpose of this study was to investigate the accumulation of technetium-99m pertechnetate (99mTc) in malignant soft-tissue tumors. Twenty-one patients with malignant soft-tissue tumors were subjected to 99mTc scintigraphic studies. In 19 of 21 patients (90%), 99mTc accumulated extensively in the tumors. 99mTc accumulation was especially thorough in all cases of MFH and liposarcoma. Therefore, 99mTc is useful for the local evaluation of malignant soft-tissue tumors.

Topics: Adolescent; Adult; Aged; Female; Histiocytoma, Benign Fibrous; Humans; Liposarcoma; Male; Middle Aged; Neurilemmoma; Radionuclide Imaging; Rhabdomyosarcoma; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms

Three soft tissue tumors were studied with 99mTc-pertechnetate scintigraphy, 67Ga-citrate scintigraphy and MRI. These tumors included schwannoma, neurofibromatosis and malignant fibrous histiocytoma. On 99mTc-pertechnetate scintigram all patients showed more increased accumulation corresponding to the tumor than on 67Ga-citrate scintigram. In conclusion, 99mTc-pertechnetate scintigraphy may be useful in detection of soft tissue tumors.

Topics: Adolescent; Citrates; Citric Acid; Evaluation Studies as Topic; Female; Histiocytoma, Benign Fibrous; Humans; Middle Aged; Neurilemmoma; Neurofibromatoses; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms

Red blood cells labeled with technetium Tc 99m were used to evaluate the vascular nature of a subcutaneous tumor in a 12-year-old girl. The low perfusion and high blood pool that characterized the lesion were considered highly suggestive of subcutaneous cavernous hemangioma. This noninvasive method for diagnosing soft tissue hemangiomas is more specific than other imaging modalities such as ultrasound and arteriography. The usefulness and the importance of the method prior to surgical biopsy or resection are discussed.

Topics: Child; Erythrocytes; Female; Forearm; Hand; Hemangioma; Humans; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms

Topics: Child; Humans; Hyperparathyroidism, Secondary; Male; Mandibular Neoplasms; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Subtraction Technique; Thallium Radioisotopes

Topics: Adolescent; Bone Neoplasms; Child; Child, Preschool; Diagnosis, Differential; Diphosphates; Evaluation Studies as Topic; Humans; Infant; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Adolescent; Adult; Child; Female; Fibroma; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Technetium

Topics: Adult; Erythrocytes; Female; Hemangioma, Cavernous; Humans; Knee; Neoplasm Recurrence, Local; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Technetium

Two classes of radiopharmaceuticals may be used for imaging tumors of the musculoskeletal system. The first is comprised of soft tissue or tumor specific agents such as gallium-67, bleomycin, and radionuclide-labeled antibodies, which may be useful for detecting and localizing these tumors. The other class of tracer is comprised of those with avidity for bone. The 99mTc-labeled-phosphate skeletal imaging compounds have been found to localize in a variety of soft tissue lesions, including benign and malignant tumors. In 1972, Enneking began to include bone scans in the preoperative evaluation of soft tissue masses. Later, he and his associates reported that these scans were useful in planning operative treatment of sarcomas by detecting involvement of bone by the tumors. Nearly all malignant soft tissue tumors take up bone-seeking radiopharmaceuticals, and bone involvement was indicated in two-thirds of the scans we reviewed. About half of benign soft tissue lesions had normal scans, but the other half showed uptake within the lesion and a few also showed bone involvement. Careful, thorough imaging technique is essential to proper evaluation. Multiple, high-resolution static gamma camera images in different projections are necessary to adequately demonstrate the presence or absence of soft tissue abnormality and to define the precise relationship of the tumor to the adjacent bone.

Topics: Bleomycin; Bone Neoplasms; Diphosphonates; Gallium Radioisotopes; Humans; Methods; Radionuclide Imaging; Sarcoma; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Technetium; Technetium Compounds