technetium-tc-99m-gluceptate and Carcinoma--Bronchogenic

Topics: Carcinoma, Bronchogenic; Female; Humans; Lung Neoplasms; Lymphatic Metastasis; Middle Aged; Organotechnetium Compounds; Radiography; Radionuclide Imaging; Sugar Acids; Technetium

Tc-99m sestamibi has been used to detect primary brain and lung tumors. The authors report a patient who underwent brain imaging to differentiate tumor from abscess in the cerebellum because of a ring-like enhancement lesion on a brain CT scan. An abnormal area of increased sestamibi uptake in the right cerebellum was demonstrated planar and on a SPECT imaging. The removed tumor was confirmed to be poorly differentiated metastatic carcinoma.

Topics: Aged; Carcinoma, Bronchogenic; Cerebellar Neoplasms; Humans; Lung Neoplasms; Male; Organotechnetium Compounds; Sugar Acids; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon

Topics: Bronchoscopy; Carcinoma, Bronchogenic; Humans; Lung Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium

It has been shown by Vorne et al. and Passamonte et al. that technetium-99m-glucoheptonate (Tc-GH) concentrates in bronchial carcinomas. The two studies reported similar sensitivities (88 and 91%, respectively) but discordant specificities (88 and 10%, respectively). In order to assess the uptake of Tc-GH in bronchial carcinomas we performed lung imaging on patients with an abnormal chest radiograph who were undergoing routine investigations for bronchial carcinoma. 108 patients (85 carcinoma, 23 non-carcinoma) were given 555 MBq (15 mCi) Tc-GH intravenously and scanned 5 h later. Images were assessed by one investigator (J.A.L.) without knowledge of the patient's clinical details or other results. Localized uptake of Tc-GH was seen in 71 out of 85 patients who proved to have bronchial carcinoma. Uptake was also seen in 16 out of 23 patients with a variety of non-malignant lung conditions. Sensitivity for bronchial carcinoma was 84%, and specificity 30%. Uptake did not vary significantly with histology. Eleven out of 12 patients with proven tuberculosis had increased uptake of Tc-GH; two of those patients also had inactive lesions which did not concentrate the tracer. In conclusion, Tc-GH is of limited value in the diagnosis of bronchial carcinoma, because of its low specificity. A possible role in the diagnosis of active tuberculosis may exist, following further assessment.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Bronchogenic; Female; Humans; Lung; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium

We prospectively studied technetium-99m glucoheptonate (Tc-GHA) uptake in 58 patients with newly diagnosed lung cancer and in 20 patients with pulmonary inflammatory disease or metastatic carcinoma. Fifty-three (91%) primary tumors accumulated Tc-GHA: squamous cell 20/22, adenocarcinoma 7/7, large cell 10/11, and small cell 16/18. Intensity of tumor uptake was greatest in small-cell cancer. Supraclavicular metastases were detected in two patients. Fourteen patients with mediastinal evaluation by Tc-GHA imaging and trispiral tomography underwent mediastinoscopy or thoracotomy. Five of ten patients with negative mediastinum by tomography and Tc-GHA imaging showed metastases by biopsy (false-negative Tc-GHA). Less intense accumulation of Tc-GHA was observed in 18/20 cases of pulmonary inflammatory disease or pulmonary metastases. Although Tc-GHA accumulates by an unknown mechanism in primary lung cancer, we cannot recommend its use in detecting mediastinal spread of lung cancer due to its unacceptably high false-negative rate.

Topics: Adenocarcinoma; Carcinoma, Bronchogenic; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Histoplasmosis; Humans; Lung Diseases; Lung Neoplasms; Mediastinal Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium