technetium-tc-99m-gluceptate and Brain-Diseases

Topics: Acquired Immunodeficiency Syndrome; Adult; Biopsy; Brain; Brain Diseases; Diagnosis, Differential; Electroencephalography; Encephalitis; Herpes Simplex; Humans; Male; Opportunistic Infections; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium; Toxoplasmosis

Intracerebral lesions demonstrated by computerized tomography usually require histological confirmation to determine subsequent management. Tissue samples are generally obtained by craniotomy or burr hole biopsy; either procedure can prove negative if a lesion is small, deep, or very superficial. Pre-operative imaging and localization reduce biopsy failures. Before the introduction of this straight forward radionuclide technique, our biopsy success rate using conventional localization methods was 88%. In a 5-year period, 200 patients underwent pre-operative radionuclide localization, with an improvement in the overall biopsy success rate to 92.7% (95.5% for lesions which took up radionuclide). Patients have benefitted from reduced operating time and improved post-operative recovery rates. About 85% of all intracerebral lesions may be expected to accumulate radionuclide. However in our series, 93.2% were sufficiently well visualized for a siting marker to be placed with confidence. Within this group, low grade astrocytomas (Kernohan Grades I and II) showed a predictably low incidence of imaging (30.8%). For the majority of lesions which present difficulties in biopsy due to size or site, the radionuclide method is a simple procedure which increases the chance of obtaining positive tissue with the minimum of surgical intervention.

Topics: Biopsy; Brain; Brain Diseases; Brain Neoplasms; Female; Humans; Male; Middle Aged; Organotechnetium Compounds; Preoperative Care; Radionuclide Imaging; Sugar Acids; Technetium

Over the past decade, many of the prime indications for radionuclide brain scanning have become instead indications for CCT, and nuclear medicine studies of the brain have assumed more of a complementary, supportive role. However, there is great promise for improvement in central nervous system radionuclide applications with advances anticipated in both radiopharmaceuticals and instrumentation. Nuclear medicine is continuing to function as a powerful research tool and, in the relatively near future, may regain its role as a major clinical test of the central nervous system.

Topics: Brain Abscess; Brain Death; Brain Diseases; Brain Injuries; Brain Neoplasms; Cerebrospinal Fluid Shunts; Cerebrovascular Disorders; Diagnosis, Differential; Humans; Hydrocephalus; Intracranial Arteriovenous Malformations; Meningitis; Organotechnetium Compounds; Pentetic Acid; Radionuclide Imaging; Sinus Thrombosis, Intracranial; Spinal Cord Diseases; Sugar Acids; Technetium; Technetium Tc 99m Pentetate

Sixteen patients with known cerebral disease had one- and two-hour delayed brain scans following intravenous injection of 15 mCi of technetium-99m glucoheptonate. No abnormalities were seen on the two-hour images that were not detected on the one-hour delayed scan. There were two false negative scans. Of the 14 true positives, 10 were visualized equally well in the one-and two-hour delayed images, two were better seen on two-hour images, and two were better on one-hour scans. As no difference in lesion detection was found, consideration of reducing the post-dose delay time two hours to one seems warranted.

Topics: Brain; Brain Diseases; Brain Neoplasms; Evaluation Studies as Topic; False Negative Reactions; Humans; Intracranial Arteriovenous Malformations; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium; Time Factors

Topics: Brain; Brain Abscess; Brain Diseases; Brain Neoplasms; Cerebrovascular Disorders; Glioblastoma; Humans; Meningioma; Organotechnetium Compounds; Pentetic Acid; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Sugar Acids; Technetium; Tomography, X-Ray Computed; Wounds and Injuries

Topics: Brain Diseases; Humans; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium; Time Factors

Both early and delayed Tc-99m glucoheptonate brain images were evaluated in 859 patients in order to determine whether the early imaging with this agent is clinically useful. The results suggest that the early brain images are inferior to the delayed ones in detecting CNS lesions. Use of both, however, may help to differentiate skull or scalp abnormalities from true lesions of the brain.

Topics: Adult; Aged; Brain; Brain Diseases; Child, Preschool; Diagnosis, Differential; Female; Humans; Male; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium; Time Factors