technetium-tc-99m-medronate and Thoracic-Neoplasms

Topics: Female; Hemangioma, Cavernous; Humans; Middle Aged; Radionuclide Imaging; Ribs; Technetium Tc 99m Medronate; Thoracic Neoplasms; Tomography, X-Ray Computed; Whole Body Imaging

To document the varied radiological features before, during, and after treatment of non-Central Nervous System Primitive Neuroectodermal Tumours (PNETs), which are rare tumours of childhood.. Thirty-three children with PNETs have been treated at our institution between 1990 and 1999. Full radiological and clinical follow-up was obtained in 29 (17 females, 12 males). Imaging was retrospectively reviewed, with particular attention to Computed Tomography (CT) and Magnetic Resonance Imaging (MRI).. Age range at diagnosis was 0-16 years old (mean 4.4 years). There were five main sites of tumour: head and neck (n = 7), scapula/axilla (n = 2), chest (n = 11), abdomen (n = 3), and spinal/paraspinal (n = 6). Overall mortality was 62%. Tumours of the scapula or paraspinal region appear to show better survival than other sites. Of 23 patients who had Tc99m-methylene diphosphonate (MDP) bone scans at diagnosis, four patients showed widespread distant metastases, seven showed focal increased uptake in an adjacent bone only, and 12 had normal examinations. CT was performed in 25 patients and MRI in 20, both at diagnosis and follow-up. Average size of tumours at presentation was 4.5 cm in the paraspinal, head and neck and scapular regions and 7.5 cm in the chest and abdomen. Tumours were typically of soft tissue density on CT with the larger (>5 cm) masses tending to be more heterogeneous in character. The lesions were slightly higher signal than muscle on T1-weighted (T1W) MRI and all masses were heterogeneous on T2W sequences. Calcification was uncommon (n = 6) and generally sparse. Tumours tended to displace adjacent soft tissue structures such as vessels and bronchi rather than invade or encase them. Tumours rarely crossed the midline. Local or bony invasion was seen in 12 patients at diagnosis. Metastases were identified in the lung (n = 5), pleura (n = 2), brain (n = 4), bone (n = 4), lymph nodes (n = 2), liver (n = 2), subcutaneous tissues (n = 2), kidney (n = 1) and peritoneum (n = 1).. Imaging characteristics of non-CNS PNETs are described. Tumours tend to displace rather than encase adjacent structures; local invasion occurred in 43%. Tumour calcification is uncommon. Poor prognostic features included the presence of distant metastases at diagnosis (all four patients with distant metastases at diagnosis died), but even patients without metastatic disease have a relatively poor prognosis.

Topics: Abdominal Neoplasms; Adolescent; Child; Child, Preschool; Disease-Free Survival; Female; Head and Neck Neoplasms; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neuroectodermal Tumors, Primitive, Peripheral; Prognosis; Retrospective Studies; Spinal Neoplasms; Technetium Tc 99m Medronate; Thoracic Neoplasms; Tomography, X-Ray Computed

Topics: Aged; Bone Neoplasms; Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Male; Middle Aged; Photons; Radionuclide Imaging; Radiopharmaceuticals; Ribs; Shoulder; Spinal Neoplasms; Sternum; Technetium Tc 99m Medronate; Thoracic Neoplasms

Superimposition of SPECT and computed tomography (CT) slices from the thoracoabdominal region was achieved without the use of external markers for 14 studies in 13 patients with endocrine carcinoma. Technical feasibility and clinical validation of this retrospective fusion method were assessed.. Patients had a history of thyroid cancer or of carcinoid tumor. To detect tumor sites, CT scan and dual-isotope tomoscintigraphy were performed, with 99mTc-hydroxymethylene diphosphonate for bone scintigraphy and with 111In-pentetreotide, 131I or 131I-metaiodobenzylguanidine for tumor scintigraphy (TS). A superimposition method previously developed for the pelvic region was adapted to the nonrigid thoraco-abdominal region. CT-bone scintigraphy and CT-TS superimposed images were obtained. Clinical validation of the information obtained from the superimposed images was obtained from surgery or follow-up imaging studies performed after clinical evolution of the disease process.. Reliable and reproducible registration was achieved in all patients. CT-TS superimposed images produced accurate localization of abnormal TS foci. Accuracy was limited primarily by variable relative displacements of the thoracoabdominal organs. For 10 sites in 8 patients, localization and/or characterization obtained from CT-TS images was confirmed by a reference technique. Superimposition enabled the localization of tumor sites that otherwise could not have been suspected from CT alone and allowed the characterization of CT suspicious masses and the confirmation of CT positive sites. Nonspecific tumor TS uptake sites were also localized.. With standard CT and dual-isotope SPECT acquisitions, SPECT-CT fusion is feasible in the thoracoabdominal region without the use of external markers. Fused images were validated in 8 patients for 10 sites. The use of this technique could probably improve the management and care of patients with endocrine carcinoma.

Topics: 3-Iodobenzylguanidine; Abdominal Neoplasms; Carcinoid Tumor; Carcinoma, Medullary; Feasibility Studies; Humans; Image Processing, Computer-Assisted; Indium Radioisotopes; Iodine Radioisotopes; Iodobenzenes; Octreotide; Pentetic Acid; Radiopharmaceuticals; Reproducibility of Results; Retrospective Studies; Technetium Tc 99m Medronate; Thoracic Neoplasms; Thyroid Neoplasms; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Separate imaging studies employing Tc-99m MDP, In-111 labeled leukocytes, and Tc-99m SC were performed in a patient receiving external beam radiation therapy to the mediastinum and left hemithorax. The leukocyte scan demonstrated greatly increased activity at the site of the radiation port. The bone marrow (sulfur colloid) scan was normal and the bone scan demonstrated only minimally increased activity in the irradiated region. The varying appearance of these scans may represent the difference in the early effect of radiation on bone and bone marrow elements.

Topics: Bone Marrow; Carcinoma, Renal Cell; Humans; Indium Radioisotopes; Leukocytes; Male; Mediastinal Neoplasms; Middle Aged; Radionuclide Imaging; Radiotherapy, High-Energy; Ribs; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms; Thoracic Vertebrae

Topics: Child; Diagnosis, Differential; Female; Humans; Lipoma; Magnetic Resonance Imaging; Neoplasm Invasiveness; Technetium Tc 99m Medronate; Thoracic Neoplasms; Tomography, X-Ray Computed

Eighty-Six patients of neuroblastoma ranging in age from four months to 15 years were studied with 99m Tc-MDP for total skeletal survey over a period of seven years (1983-1990). The diagnosis of neuroblastoma was based on bone marrow examination, FNAC, lymph node biopsy, histopathology. Bone imaging was performed three hrs. after intravenous administration of 99m Tc-MDP. Out of 86 patients, 45 patients had positive bone scan showing osseous concentration in 122 sites and extraosseous concentration in 34 sites. Seven patients had liver metastases. None of these liver metastases showed concentration of MDP. Fourteen patients underwent surgery for the primary tumour at the time of bone scanning. Ten patients were studied at the time of follow up, of which four patients showed good response as bony metastases were not demonstrated on bone scintigraphy and X-rays. In conclusion, bone scan is an useful test in neuroblastoma in delineating the bony metastases and also in assessing the efficacy of chemotherapy in these patients.

Topics: Abdominal Neoplasms; Adolescent; Bone and Bones; Bone Neoplasms; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Male; Neuroblastoma; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Medronate; Thoracic Neoplasms

Alpha-aminoisobutyric acid (AIB), a synthetic, nonmetabolized amino acid which is rapidly transported into viable cells by the A-type or alanine-preferring amino acid transport system, has been labeled with the short-lived, positron-emitting radionuclide carbon-11. Carbon-11 labeled AIB is currently being evaluated as a tumor imaging agent for in vivo amino acid transport studies in patients with cancer. In this study, C-11 AIB was used to image two patients with malignant fibrous histiocytoma (MFH), a pleomorphic sarcoma. Following intravenous administration of C-11 AIB, tumors in the distal femur of one patient and in the anterior chest wall of another patient were well visualized using high energy gamma scintigraphy. Since therapy may alter the accumulation of amino acids in tumor tissue, studies using C-11 AIB in patients with MFH before and after chemotherapy are in progress.

Topics: Adult; Aminoisobutyric Acids; Carbon Radioisotopes; Female; Femoral Neoplasms; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Thoracic Neoplasms

Topics: Bone Neoplasms; Diphosphonates; Female; Humans; Ilium; Middle Aged; Osteosarcoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Thoracic Neoplasms

Accumulation of Tc-99m labeled phosphonate bone scanning agent in a pleural effusion usually shows a mild and diffuse increase in radioactivity of the involved thorax. A malignant neoplasm was thought to account for this accumulation. The photon deficiency of the hemithorax on Tc-99m HMDP bone scintigraphy was shown in a case of massive pleural effusion, which was proved by autopsy to be due to metastatic breast carcinoma in the pleura. Two factors caused these scintigraphic findings: 1) a large amount of fluid in the pleural cavity caused photon attenuation; 2) the higher body background in the noninvolved hemithorax and other areas of the body was due to renal dysfunction resulting from chronic pyelonephritis. Whether the accumulation of the radiopharmaceutical agent in the pleural effusion was malignant or benign could not readily be distinguished.

Topics: Adult; Bone Neoplasms; Breast Neoplasms; Female; Humans; Pleural Effusion; Radionuclide Imaging; Technetium Tc 99m Medronate; Thoracic Neoplasms

Sixty-six percent of 54 patients with neuroblastoma demonstrated uptake of bone-seeking radioagents by the primary tumor. This is a higher incidence than previously reported. Uptake was slightly more common in abdominal than thoracic tumors. There was a significant correlation between the size of the tumor and tracer uptake. Calcification was demonstrated in the primary tumor in almost 90% of the 54 patients. This is a much higher incidence of calcification than previously reported. Microscopy shows that the calcification is not always due to tumor necrosis; it also occurs in areas of viable tumor cells. Tracer uptake is believed to be related to calcium metabolism. The rate of metabolic activity rather than the total amount of calcium present within the tumor may be the most important factor in determining the amount of uptake. No significant relationship was found between tracer uptake and tumor stage or homovanillic acid and vanillylmandelic acid metabolic activity.

Topics: Abdominal Neoplasms; Bone and Bones; Calcinosis; Diphosphonates; Etidronic Acid; Female; Homovanillic Acid; Humans; Infant; Male; Neuroblastoma; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Thoracic Neoplasms; Vanilmandelic Acid

Topics: Bone and Bones; Child, Preschool; Diphosphonates; Humans; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Thoracic Neoplasms; Wilms Tumor