succimer and Soft-Tissue-Neoplasms

We report a case of metastatic insular carcinoma of the thyroid evaluated with 201TI, 99mTc-MIBI, 99mTc-(V)DMSA, 99mTc-MDP and 131I whole-body scans, which were obtained after total thyroidectomy. For the majority of lesions detected in the skeleton and soft tissue, 131I images were generally available, although most were visualized easier with 99mTc-(V)DMSA. Technetium-99m-MDP images were considered better than 99mTc-(V)DMSA images in showing bone lesions but not soft-tissue lesions. Both 201TI and 99mTc-MIBI scans provided sufficient advantage to exhibit neck and mediastinal metastases, but they did not surpass 99mTc-(V)DMSA in detecting abdominal or bony lesions. In this patient with various metastases from insular carcinoma of the thyroid, 99mTc-(V)DMSA seemed to be the tracer of choice for whole-body imaging.

Topics: Bone Neoplasms; Carcinoma, Medullary; Female; Humans; Iodine Radioisotopes; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Thyroid Neoplasms

Radionuclide scanning with tumour-seeking agents such as pentavalent technetium-99m dimercaptosuccinic acid [99mTc(V)-DMSA], thallium-201 and technetium-99m sestamibi (MIBI) has been reported to be useful in the detection of medullary thyroid carcinoma (MTC). We undertook a study in 14 MTC patients to determine the comparative imaging potential of 201Tl, MIBI and 99mTc(V)-DMSA in the detection of recurrent or metastatic MTC. All patients underwent total thyroidectomy and had persistently elevated serum calcitonin levels after the surgery. Scintigraphic studies were carried out 20 min after the injection of 111 MBq of 201Tl or 555 MBq of MIBI and 2 h following the injection of 370 MBq of 99mTc(V)-DMSA. All scintigraphic findings were correlated with contemporaneous CT or MRI studies. CT, MRI and bone scans showed 42 (26 bone, 16 soft tissue) metastatic sites in 11 of the 14 patients. In the remaining three patients no lesions were detected during diagnostic evaluation. 99mTc(V)-DMSA showed all of the soft tissue metastases but could not show two bone lesions. On the other hand, MIBI imaging was false-negative in 22 (52%) sites and 201Tl was false-negative in 34 (80%) sites. Overall, lesion detection sensitivities for 99mTc(V)-DMSA, MIBI and 201Tl were 95%, 47% and 19% respectively. We conclude that 99mTc(V)-DMSA is clearly superior to MIBI and 201Tl in the follow-up of MTC patients.

Topics: Adult; Aged; Bone Neoplasms; Calcitonin; Carcinoma, Medullary; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Organotechnetium Compounds; Radionuclide Imaging; Sensitivity and Specificity; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Thyroid Neoplasms

To assess the potential of technetium-99m (V) dimercaptosuccinic acid (DMSA) scintigraphy for diagnosis of soft-tissue tumors.. Tc-99m (V) DMSA scintigraphy was performed in 76 patients with histologic proof of soft-tissue tumors. In 57 of these patients, gallium-67 citrate scintigraphy was performed within 2 weeks after Tc-99m (V) DMSA scintigraphy.. Uptake of Tc-99m (V) DMSA was clearly detected in almost all sarcomas, metastatic carcinomas, highly recurrent benign tumors (ie, extra-abdominal desmoids and tenosynovial giant cell tumors), superficial and deep hemangiomas, and granulomatous soft-tissue lesions but was not found in other benign solid tumors of soft tissue. Uptake of Ga-67 citrate was clearly detected in all inflammatory lesions and metastatic carcinomas, eight of 14 sarcomas (57%), and two of 10 highly recurrent benign tumors (20%) but was not found in hemangiomas or benign soft-tissue tumors.. Low-grade malignant and highly recurrent benign lesions, which often recur after surgery, were detected more accurately with Tc-99m (V) DMSA scintigraphy than with Ga-67 citrate scintigraphy.

Topics: Adolescent; Adult; Aged; Child; Citrates; Citric Acid; Female; Gallium Radioisotopes; Humans; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sensitivity and Specificity; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid

Combined Tc-99m MDP skeletal imaging and Tc-99m(V) DMSA whole body scans to detect metastases were performed during the follow-up of 30 patients who underwent surgery for breast carcinoma. Eight patients had normal Tc-99m MDP and Tc-99m(V) DMSA scans and were declared free of metastatic disease, further confirmed by no change in symptomatology over a 1-year follow-up period. Twenty-two patients had positive Tc-99m MDP scans with varied skeletal involvement. Tc-99m(V) DMSA scans showed matched areas of increased radiotracer concentration in bony metastases in 20 of these patients. Tc-99m(V) DMSA concentration was not seen in traumatic vertebral collapse or in coexistent osteoarthritic disease in vertebral metastatic involvement. Interestingly, Tc-99m(V) DMSA showed increased concentration in brain and liver metastases. Pentavalent Tc-99m(V) DMSA appears useful for detecting skeletal and soft-tissue metastases in breast carcinoma, and can improve the specificity of Tc-99m MDP bone scans in screening for bone metastases.

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Evaluation Studies as Topic; Female; Humans; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sensitivity and Specificity; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate

Ten patients with suspected primary, recurrent or metastatic medullary carcinoma of the thyroid (MCT) were studied prospectively with Tc-99m(V) DMSA. Of these, two patients had primary disease, seven patients were asymptomatic but had persistent and serial elevations in serum calcitonin following previous thyroid resections for MCT, and one asymptomatic patient with normal serum calcitonin was studied because of suspected hilar nodes metastases. The serial calcitonin peak in the patients was 0.04-43ng/ml (normal less than 0.08ng/ml). Scintigraphy was considered positive in seven of the asymptomatic patients and equivocal in one. The two patients with primary disease had increased uptake before but not after thyroidectomy. Primary disease, localized recurrence and distant metastases in soft tissue (nine patients) and bone (one patient) were detected in these patients, and this resulted in early surgical resection (five patients) and radiotherapy (one patient). We conclude that Tc-99m(V) DMSA is a useful imaging agent in the evaluation of asymptomatic MCT patients with hypercalcitonemia.

Topics: Adult; Aged; Bone Neoplasms; Carcinoma; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Organotechnetium Compounds; Prospective Studies; Radionuclide Imaging; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Neoplasms

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

Two cases of alveolar soft part sarcoma were examined with gallium-67 citrate (67Ga), technetium-99m-methylenediphosphate (99mTc-MDP) and technetium-99m(V)-dimercaptosuccinic acid (Tc(V)-DMS) to compare the sensitivity of these three radiopharmaceuticals. All scintigrams were positive with primary tumor, and images with Tc(V)-DMS were the best. Skull metastasis could be also detected by all agents, but scintigrams with lung metastases were negative. In scintigraphic evaluation of alveolar soft part sarcoma, Tc(V)-DMS may be a better agent than 67Ga or 99mTc-MDP.

Topics: Adult; Citrates; Citric Acid; Humans; Male; Organotechnetium Compounds; Radionuclide Imaging; Sarcoma; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate

Topics: 3-Iodobenzylguanidine; Adult; Aged; Aged, 80 and over; Bone Neoplasms; Carcinoma; Evaluation Studies as Topic; Humans; Iodine Radioisotopes; Iodobenzenes; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Organometallic Compounds; Radionuclide Imaging; Soft Tissue Neoplasms; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Neoplasms

The effectiveness of Tc-99m bleomycin (BLM) and Tc(V)-99m DMSA are compared with that of Ga-67 citrate, which is currently the most widely used agent. In four patients with lipomatous tumors, the clinical significance of tumor imaging with each of these three agents is discussed and compared. Results indicate that both Tc-99m BLM and Tc(V)-99m DMSA are superior in detecting the extension or localization of liposarcomas.

Topics: Adult; Bleomycin; Female; Gallium Radioisotopes; Humans; Liposarcoma; Male; Middle Aged; Organometallic Compounds; Organotechnetium Compounds; Radionuclide Imaging; Soft Tissue Neoplasms; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Thigh

Tumor scintigraphy, using Tc(V)-99m dimercaptosuccinic acid (Tc(V)-DMS) was performed in 58 patients with soft tissue tumors, and the results were compared with that of Ga-67 citrate. Tc(V)-DMS was found to have a sensitivity of 90% for malignant tumors including aggressive fibromatosis compared to that of Ga-67 citrate, which was 56%. However, the specificity of Tc(V)-DMS for these tumors was 71% but with Ga-67 citrate the specificity was 80%. The imaging accuracy in soft tissue tumors with Tc(V)-DMS and Ga-67 citrate was 78% and 71%, respectively. Although the accumulation of Tc(V)-DMS has been detected in some benign soft tissue tumors, the reduced accumulation in inflammatory lesions compared to Ga-67 citrate was recognized, and Tc(V)-DMS could be of great use in the detection of extension or location of malignant soft tissue tumors.

Topics: Abscess; Adult; Aged; False Negative Reactions; False Positive Reactions; Female; Fibroma; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Lipoma; Male; Middle Aged; Neurilemmoma; Neuroectodermal Tumors, Primitive, Peripheral; Radionuclide Imaging; Soft Tissue Neoplasms; Succimer; Sulfhydryl Compounds; Synovitis; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid