succimer and Head-and-Neck-Neoplasms

Topics: Head and Neck Neoplasms; Humans; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid

This study was undertaken to compare clinical evaluation of the neck with 99mTc(v) DMSA planar scintigraphy and computerized tomography (CT) in patients with head and neck carcinoma. Twenty-six patients were studied and in all but one the neck was previously untreated. A total of 31 neck dissections were performed and the specimens examined histopathologically. CT was approximately as accurate (71%) as clinical examination (68%) and more accurate than 99mTc(v) DMSA planar scintigraphy (48%) in predicting which necks contained metastatic carcinoma. Overall, 13% of necks had their staging correctly changed by 99mTc(v) DMSA scintigraphy compared with 10% for CT. Although scintigraphy upstaged 13% of clinically N0 necks compared to 6% for CT, it was less sensitive and specific than either clinical examination or CT. 99mTc(v) DMSA planar scintigraphy has no role to play in the investigation of patients with metastatic carcinoma to include the clinically N0 neck.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Lymph Node Excision; Male; Middle Aged; Neoplasm Staging; Organotechnetium Compounds; Palpation; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, X-Ray Computed

Technetium-99m (99Tcm) (V) dimercaptosuccinic acid (DMSA) is a new tumour imaging agent that has been used to image squamous cell carcinoma (SCC) of the head and neck. This study has been undertaken to compare clinical examination with computed tomography (CT) (anatomical) and SPECT 99Tcm (V) DMSA (physiological) imaging in the evaluation of metastatic SCC of the neck. Twenty-five patients with head and neck cancer were studied. Computed tomography was as sensitive but more accurate than clinical examination in predicting the presence of cancer. SPECT 99Tcm (V) DMSA was inferior to both techniques in identifying metastatic disease. There is no role for SPECT 99Tcm (V) DMSA imaging in the management of patients with SCC metastatic to the neck. Combined imaging with CT offered no advantages over anatomical imaging with CT alone. There is no role for CT in the routine evaluation of the clinically N0 neck and the role of CT of the neck in the management of patients with metastatic SCC is discussed.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organotechnetium Compounds; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organotechnetium Compounds; Sensitivity and Specificity; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed, Single-Photon

In patients with cervical metastases conventional examination by ultrasound, CT or MRI imaging often fails to identify an unknown primary tumor. Also the retrieval of a recurrent malignancy may be difficult. Scintigraphy, utilizing technetium-99m (v) dimercaptosuccinic acid was chosen for a prospective study in 17 patients to evaluate its properties for imaging metastasizing squamous cell carcinoma of the head and neck. Scintigraphic findings were correlated with the results of clinical examination and conventional imaging techniques. In all cases the primary tumor revealed good uptake of 99mTc(v)DMSA. Manifest cervical metastases could only be imaged in some cases. In future, therefore, 99mTc(v)DMSA scanning may be used for the detection of unknown primary tumors. However, it does not appear helpful in the evaluation of cervical nodes.

Topics: Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Hypopharyngeal Neoplasms; Laryngeal Neoplasms; Lymphatic Metastasis; Mouth Neoplasms; Neoplasm Staging; Organotechnetium Compounds; Oropharyngeal Neoplasms; Prospective Studies; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed, Single-Photon

Technetium-99m (99mTc) (v) dimercaptosuccinic acid (DMSA) is a new tumour-imaging agent which has been used to image head and neck squamous carcinoma. This study used an established rabbit tumour model to compare palpation versus planar scintigraphy in the detection of superficially transplanted cancers. Palpation detected 83% of tumours measuring less than 2 cm compared with 58% for scintigraphy. Overall, the sensitivity for palpation was 88% (77% specificity) compared with 50% (63% specificity) for scintigraphy.

Topics: Animals; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Neoplasm Transplantation; Organotechnetium Compounds; Palpation; Rabbits; Radionuclide Imaging; Sensitivity and Specificity; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid

Topics: Female; Head and Neck Neoplasms; Humans; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sarcoma; Sodium Pertechnetate Tc 99m; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Gland

Technetium-99m (99Tcm) (v) dimercaptosuccinic acid (DMSA) is a new tumour imaging agent which has been used to image medullary carcinoma of the thyroid and squamous cell carcinoma (SCC) of the head and neck. This study was undertaken to compare planar scintigraphy in patients with head and neck SCC using 99Tcm (v) DMSA and the established tumour imaging agent gallium-67 citrate (67Ga). Seventeen patients were studied of whom 16 had a head and neck malignancy. Clinical examination was more sensitive and accurate than 67Ga scintigraphy, which in turn was more sensitive and accurate than 99Tcm (v) DMSA in detecting patients with cancer, patients with primary tumours and patients with metastatic neck carcinoma. Neither 67Ga or 99Tcm (v) DMSA planar scintigraphy has any role to play in the routine evaluation at presentation of patients with head and neck SCC.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Citrates; Citric Acid; Female; Gallium Radioisotopes; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid

Technetium-99m (99Tcm) (v) dimercaptosuccinic acid (DMSA) is a new tumour imaging agent which has been used to image squamous cell carcinoma (SCC) of the head and neck. This study was undertaken to compare planar versus SPECT 99Tcm (v) DMSA scintigraphy in patients with head and neck SCC. Thirty-four patients were studied. Twenty-eight had SCC, and of these, four had received previous treatment with surgery or irradiation. SPECT was as sensitive and as accurate as clinical examination (but more sensitive and accurate than planar scintigraphy) in detecting which patients had cancer and which patients had primary tumours. SPECT was more sensitive and more accurate than planar scintigraphy (but less sensitive and accurate than clinical examination) in detecting lateral neck compartments with metastatic carcinoma. SPECT correctly upstaged 6% of clinically N0 necks. Although SPECT 99Tcm (v) DMSA scintigraphy improved the image quality, sensitivity and spatial resolution of the investigation, it has no role to play in the routine evaluation of patients with head and neck SCC (to include the clinically N0 neck).

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organotechnetium Compounds; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed, Single-Photon

Technetium-99m (99Tcm) (v) dimercaptosuccinic acid (DMSA) is a new tumour imaging agent which has been used to evaluate head and neck tumours. It has a normal head and neck biodistribution to include the lacrimal glands, nasal mucosa and the blood-pool. Seventy-seven patients were studied of whom 63 had a head and neck malignancy. Of these patients, 19 (25%) exhibited positive accumulation of radioactivity in the region of the pituitary gland and this was a constant finding in those followed-up after treatment. Biodistribution studies in forty New Zealand white rabbits confirmed pituitary accumulation of 99Tcm (v) DMSA. The pituitary gland region should be included in the normal biodistribution of 99Tcm (v) DMSA.

Topics: Adult; Aged; Aged, 80 and over; Animals; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organotechnetium Compounds; Pituitary Gland; Rabbits; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid

Technetium-99m (99Tcm)(V) dimercaptosuccinic acid (DMSA) is a new tumour imaging agent which has been used to evaluate squamous carcinoma (SCC) of the head and neck. This study evaluated the pharmacokinetics and biodistribution of 99Tcm(V)DMSA in patients with SCC and calculated the bone mass of a New Zealand White (NZW) rabbit. This data was then used to calculate the effective dose equivalent in man. A total of 16 patients were studied (5 with no tumour, 11 with tumour). 99Tcm(V)DMSA had a fast bi-exponential blood clearance in patients with no tumour (30 and 401 min) and patients with tumour (30 and 387 min) with no significant difference (p greater than 0.05) between the two groups. 99Tcm(V)DMSA had a fast cumulative urine excretion with mean half-times in non-tumour and tumour patients of 183 min and 244 min respectively. There was no significant difference (p greater than 0.05) between these two latter groups. The effective dose equivalent of 99Tcm(V)DMSA in man is 5.1 microSv/MBq.

Topics: Aged; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organotechnetium Compounds; Radiation Dosage; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid; Tissue Distribution

Technetium-99m(99Tcm) (V) dimercaptosuccinic acid is a new imaging agent which has been used to evaluate head and neck squamous cell carcinoma (SCC). This study compared the subcellular biodistribution of 99Tcm(V)DMSA in an established rabbit tumour SCC model and in humans with head and neck SCC. In rabbits, approximately 17-37% of radioactivity was located on tumour cell membrane. Approximately 57-80% of radioactivity was located nonspecifically in tumour cytosol, only 2-6% was bound specifically to tumour mitochondria, and 1-4% bound specifically to microsomes. In humans, 25-45% of radioactivity was localized on tumour cell membrane and 28-60% localized nonspecifically in tumour cytosol. There was 11-20% of radioactivity specifically bound inside the cell to the mitochondria and 1-6% specifically bound to microsomes. These results show that although 99Tcm(V)DMSA is accumulated at sites of SCC, the localization process is nonspecific.

Topics: Aged; Animals; Carcinoma, Squamous Cell; Cell Membrane; Cytosol; Female; Head and Neck Neoplasms; Humans; Male; Microsomes; Middle Aged; Mitochondria; Organotechnetium Compounds; Rabbits; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid

Technetium-99m (Tc99m)(v) Dimercaptosuccinic Acid (DMSA) is an imaging agent which has been proposed as a scintigraphic marker for head and neck squamous cell carcinoma. Fifty-four patients were studied of whom 51 had a head and neck tumour. All patients were examined and then imaged using Tc99m(v) DMSA scintigraphy and computerized tomography. Scintigraphy was less sensitive than clinical examination in the detection of patients with cancer, patients with primary tumours and patients with metastatic neck disease. CT was as sensitive and as accurate as clinical examination but more sensitive than Tc99m(v) DMSA in detecting patients with cancer and with primary tumours. CT was more sensitive and more accurate than both clinical examination and Tc99m(v) DMSA scintigraphy in predicting which patients had metastatic neck disease. Although Tc99m(v) DMSA is accumulated by squamous cell carcinoma, its inability to detect low volume disease and apparent low specificity means it has no role to play in the management of patients with head and neck squamous cell carcinoma.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Evaluation Studies as Topic; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organotechnetium Compounds; Predictive Value of Tests; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, X-Ray Computed

A recently developed imaging agent, technetium-99m (v) dimercaptosuccinic acid (99mTc (v) DMSA), has been used to assess head and neck squamous carcinoma (SCC). We have prospectively studied 62 patients of whom 53 had a histologically proven head and neck SCC. The remaining nine had benign lesions. The results of planar imaging in patients with primary disease yielded an 85% sensitivity and 78% specificity. Planar imaging in patients with cervical lymphadenopathy revealed a 59% sensitivity. Nineteen patients also had single photon emission computed tomography imaging which improved the image quality, spatial resolution and sensitivity of the investigation. Twenty-seven patients were scanned before and after radiotherapy and, of these, 96% showed positive uptake in the salivary glands with no evidence of tumor recurrence. This study has shown 99mTc (v) DMSA imaging provides a cheap and rapid method of investigating head and neck SCC and further studies are necessary to evaluate its role in the management of patients with this disease.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organometallic Compounds; Prospective Studies; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed

99Tcm-(V)-DMSA is a new tumour imaging agent which has been used to image squamous cell carcinoma (SCC) of the head and neck. There have been, however, no studies to date evaluating its optimal imaging time for SCC. Seven patients were studied (six SCC; one nontumour) and seven rabbits (six with SCC, (17 tumours); one nontumour). For the human qualitative studies there was a 67% sensitivity at 2, 4 and 6 h with image quality being optimum at 4 h. Maximum quantitative uptake occurred between 2 and 4 h. For the rabbit qualitative studies the optimum imaging time was 4 h (92% sensitivity, 100% specificity) and maximum quantitative uptake occurred at between 1.5 and 5 h. Taking into account the human and rabbit qualitative and quantitative studies combined with the pharmacokinetics and biodistribution of 99Tcm-(V)-DMSA, the optimum imaging time of 99Tcm-(V)-DMSA in humans with SCC was between 2 and 4 h.

Topics: Aged; Aged, 80 and over; Animals; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Neoplasm Transplantation; Organotechnetium Compounds; Rabbits; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid; Time Factors

99Tcm(v)-DMSA is a new tumour-imaging agent which has recently been proposed as a scintigraphic marker for head and neck squamous cell carcinoma (SCC). Seventy-seven patients were studied prospectively, of whom 58 had a history and diagnosis of head and neck SCC. All patients were examined, imaged using 99Tcm(v)-DMSA planar scintigraphy and then followed up clinically. In addition, 35 patients were followed up with scintigraphy (81 studies). Scintigraphy was less sensitive and less accurate than clinical examination for the overall detection of patients with SCC, for the detection of patients with SCC at presentation and for the detection of patients with primary tumours, possible nodal disease and with residual and recurrent disease following surgery and irradiation. Approximately 50% of patients exhibited positive uptake of 99Tcm(v)-DMSA in the salivary glands following radiotherapy. Although 99Tcm(v)-DMSA is accumulated at sites of head and neck SCC, its inability to detect low volume disease and apparent low specificity following surgery and irradiation means it has no role to play in the routine evaluation of patients with head and neck SCC.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Evaluation Studies as Topic; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid

Considering the favourable nuclear properties of 99Tcm over 67Ga, we have developed a new tumour-seeking agent, 99Tc(V)m dimercaptosuccinic acid (Tc(V)-DMSA). In order to evaluate the clinical usefulness of Tc(V)-DMSA scintigraphies, 492 patients were studied with Tc(V)-DMSA, and in some cases, where possible, the results were compared with conventional 67Ga citrate scintigraphies. There was a high degree of usefulness of Tc(V)-DMSA in patients with head and neck tumours, medullary thyroid carcinomas and soft tissue tumours. But in patients with carcinomas of the lung, liver and gastrointestinal tract, malignant melanoma and lymphoma, Tc(V)-DMSA was of no or little use.

Topics: Drug Evaluation; Gallium Radioisotopes; Head and Neck Neoplasms; Humans; Neoplasms; Organometallic Compounds; Radionuclide Imaging; Soft Tissue Neoplasms; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Neoplasms

A new imaging agent, Technetium-99m (Tc99m) (v) Dimercaptosuccinic acid (DMSA), has recently been developed which has been used to evaluate head and neck tumours. Twenty-four patients were studied of whom 21 had histologically proven SCC of the head and neck. The remaining 3 had benign lesions. Planar imaging of patients with primary disease revealed a sensitivity of 83% and a 75% specificity. The results of planar imaging of patients with cervical metastases yielded a 92% sensitivity and 100% specificity. Seven patients also had single photon emission computerized tomography (SPECT) which improved the image quality, spatial resolution and sensitivity of the investigation. Tc99m (v) DMSA imaging provides a cheap and rapid means of investigating head and neck SCC. This study suggests further work is indicated to assess its role in diagnosis and subsequent management.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organometallic Compounds; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed

Tumor scintigraphy, using Tc(V)-99m DMSA was performed on 76 patients with head and neck tumors. In 32 cases, SPECT also was performed. Tc(V)-99m DMSA was found to have a sensitivity of 75% (56 cases), a specificity of 85% (20 cases) and an accuracy of 78% on planar imaging. ECT studies showed accumulation of Tc(V)-99m DMSA in all 25 malignant cases studied. However, in benign tumors, four of seven cases (57%) showed radionuclide uptake. Tc(V)-99m DMSA has superior physical properties to Ga-67 and could be of use in the diagnosis of head and neck tumors.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Child, Preschool; Drug Evaluation; Female; Gallium Radioisotopes; Head and Neck Neoplasms; Humans; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

Topics: Gallium Radioisotopes; Head and Neck Neoplasms; Humans; Neoplasms; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

Topics: Adult; Aged; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Male; Maxillary Neoplasms; Radionuclide Imaging; Sarcoma; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid