technetium-tc-99m-sulfur-colloid and Adenocarcinoma

The interaction between the various noninvasive and invasive imaging modalities used to evaluate the liver, biliary tract, and pancreas is demonstrated in this article. By understanding this interaction and correlating noninvasive studies, the clinician will avoid diagnostic redundancy and the need for invasive testing may be reduced.

Topics: Adenocarcinoma; Biliary Tract Diseases; Biopsy, Needle; Cholangiography; Cholecystectomy; Cholelithiasis; Cholestasis; Diagnosis, Differential; Hepatectomy; Humans; Liver; Liver Diseases; Liver Neoplasms; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

Sentinel node mapping with radioactive technetium in non-small cell lung cancer has been shown to be feasible in several single institution reports. The Cancer and Leukemia Group B designed a phase II trial to test a standardized method of this technique in a multi-institutional setting. If validated, the technique could provide a more accurate and sensitive way to identify lymph node metastases.. Patients with clinical stage I non-small cell lung cancer amenable to resection were candidates for this trial. Intraoperatively, tumors were injected with technetium sulfur colloid (0.25 mCi). The tumor and lymph nodes were measured in vivo with a hand held Geiger counter and resection of the tumor and nodes was carried out. Sentinel nodes, all other nodes and the tumor were analyzed with standard histologic assessment. Negative sentinel nodes were also evaluated with immunohistochemistry.. In this phase II trial, 8 surgeons participated (1-13 patients enrolled per surgeon), and 46 patients (out of a planned 150) were enrolled. Of these, 43 patients had cancer and an attempted complete resection, and 39 patients underwent sentinel node mapping. One or more sentinel nodes were identified in 24 of the 39 patients (61.5%). The sentinel node(s) were found to be accurate (no other nodes were positive for cancer if the sentinel node was negative) in 20/24 patients (83.3%). In the overall group the sentinel node mapping procedure was found to be accurate in 20/39 patients (51.2%).. Intraoperative sentinel node mapping in lung cancer with radioisotope yielded lower accrual and worse accuracy than expected. The multi-institutional attempt at validating this technique was unsuccessful.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Carcinoma, Large Cell; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; Feasibility Studies; Female; Humans; Lung Neoplasms; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Monitoring, Intraoperative; Neoplasm Staging; Prognosis; Radionuclide Imaging; Radiopharmaceuticals; Risk Factors; Sentinel Lymph Node Biopsy; Survival Rate; Technetium Tc 99m Sulfur Colloid; Treatment Outcome

Optimal treatment of prostate cancer depends on accurate staging. Computed tomography (CT) and magnetic resonance imaging have severe limitations, and standard bone scanning can show only destructive osseous metastases. A radiolabeled antibody specific to prostatic adenocarcinoma could theoretically find evidence of soft-tissue metastases and lymph node involvement.. An immunoconjugate (CYT-356) consisting of a murine monoclonal antibody against human prostatic adenocarcinoma bound to a linker-chelator and radiolabeled with indium 111 was administered intravenously to seven patients with documented Stage D adenocarcinoma of the prostate. Planar imaging was done on days 1, 2, and 3 after injection. The CYT-356 scans were compared with standard technetium Tc99m sulfur colloid bone scans and CT scans.. Optimal imaging results were obtained on the 72-h scans. All patients had lesions on both the 99mTc-sulfur colloid bone scan and the CYT-356 scan. The location of the lesions correlated to a great extent. Two patients had positive lesions biopsied, and both biopsies showed the presence of metastatic prostatic carcinoma. There were no side effects from administration of the antibody.. In this preliminary study, CYT-356 scanning appears to be a promising agent to accomplish specific staging of prostatic carcinoma.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Bone Neoplasms; Humans; Indium Radioisotopes; Injections, Intravenous; Male; Prostatic Neoplasms; Radioimmunodetection; Reproducibility of Results; Technetium Tc 99m Sulfur Colloid

Although endoscopic resection for early gastric cancer is well established, anatomical resection with regional lymphadenectomy is recommended for lesions at high risk for occult lymph node metastasis (e.g., lymphovascular invasion, poor grade, and deep submucosal invasion). However, 75-95% high-risk early gastric cancer (HR-EGC) patients ultimately have node-negative disease and could potentially have undergone organ-sparing resection. Due to the inadequacy of standard modalities to reliably rule out nodal metastases in HR-EGC patients, sentinel lymph node (SLN) sampling was developed in Asia with promising results. However, the applicability of this technique in the West has been brought into question due to potential differences in tumor histology and body habitus. This prospective study aimed to test SLN sampling for North American EGC patients.. All patients with biopsy-confirmed T0-2 N0-1 M0 gastric adenocarcinoma at the Montreal General Hospital-McGill University Health Centre were eligible for enrollment. Esophageal and GEJ cancers were excluded due to the high rate of intrathoracic lymph node involvement. Peritumoral submucosal injection with T. From July 2016-April 2018, 253 patients with esophagogastric adenocarcinoma were evaluated. Of these, 10 met inclusion criteria (90% male, age 66(30) years). Subtotal gastrectomy was performed in nine patients (90%) and length of stay was 4 (2) days. At least one SLN basin was identified in nine cases (90%). The median #SLN basins identified was 2(2) with a median of 5(5) total SLNs retrieved per patient. In the one case for which no SLN basins were identified, only blue dye injection was used, whereas SLNs were identified in all cases using the dual tracer method. Final T-stage was pT1b/T2 in four (40%), pT1a in two (20%), and Tx in four (40%). Two patients (20%) had lymph node metastases on final pathological analysis, both of which were identified by SLN sampling (accuracy 100%; false negative rate 0%). No adverse events related to SLN retrieval were identified.. This study represents the first prospective feasibility evaluation of sentinel lymph node sampling for early gastric cancer in North America with promising preliminary results. The dual tracer method was superior to single agent blue dye in identifying sentinel nodal basins. Considerable further study is necessary to verify the safety and utility of SLN mapping in North American patients with early gastric adenocarcinoma.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Coloring Agents; Female; Gastrectomy; Humans; Lymph Node Excision; Lymphatic Metastasis; Male; Methylene Blue; Middle Aged; Neoplasm Staging; Prospective Studies; Quebec; Radiopharmaceuticals; Sentinel Lymph Node; Stomach Neoplasms; Technetium Tc 99m Sulfur Colloid

The role of sentinel lymph node (SLN) biopsy alone for staging of early-stage cervical cancer remains controversial. We aimed to determine the validity of this technique in women with early-stage cervical cancer.. We retrospectively reviewed women with early-stage cervical cancer who underwent SLN mapping followed by complete pelvic lymphadenectomy as part of initial surgical management from August 1997 through October 2015. All modes of surgical approach were included. Lymphatic mapping was performed using blue dye, technetium-99m sulfur colloid (Tc-99), and/or indocyanine green (ICG). We determined SLN detection rates, sensitivity and negative predictive value.. In these women with early-stage cervical cancer, SLN biopsy had very high sensitivity and negative predictive value. We believe it is time to change the standard of care for women with early-stage cervical cancer to SLN biopsy only.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Adenosquamous; Carcinoma, Squamous Cell; Coloring Agents; Female; Humans; Hysterectomy; Indocyanine Green; Laparoscopy; Lymph Node Excision; Lymphatic Metastasis; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Pelvis; Predictive Value of Tests; Radiopharmaceuticals; Retrospective Studies; Robotic Surgical Procedures; Sensitivity and Specificity; Sentinel Lymph Node; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid; Uterine Cervical Neoplasms; Young Adult

To compare the detection rate (DR) and bilateral optimal mapping (OM) of sentinel lymph nodes (SLNs) in women with endometrial and cervical cancer using indocyanine green (ICG) versus the standard technetium-99m radiocolloid ((99m)Tc) radiotracer plus methylene or isosulfan blue, or blue dye alone.. From October 2010 to May 2015, 163 women with stage I endometrial or cervical cancer (118 endometrial and 45 cervical cancer) underwent SLN mapping with (99m)Tc with blue dye, blue dye alone, or ICG. DR and bilateral OM of ICG were compared respectively with the results obtained using the standard (99m)Tc radiotracer with blue dye, or blue dye alone.. SLN mapping with (99m)Tc radiotracer with blue dye was performed on 77 of 163 women, 38 with blue dye only and 48 with ICG. The overall DR of SLN mapping was 97, 89, and 100 % for (99m)Tc with blue dye, blue dye alone, and ICG, respectively. The bilateral OM rate for ICG was 85 %-significantly higher than the 58 % obtained with (99m)Tc with blue dye (p = 0.003) and the 54 % for blue dye (p = 0.001). Thirty-one women (19 %) had positive SLNs. Sensitivity and negative predictive value of SLN were 100 % for all techniques.. SLNs mapping using ICG demonstrated higher DR compared to other modalities. In addition, ICG was significantly superior to (99m)Tc with blue dye in terms of bilateral OM in women with early stage endometrial and cervical cancer. The higher number of bilateral OM may consequently reduce the overall number of complete lymphadenectomies, reducing the duration and additional costs of surgical treatment.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Coloring Agents; Endometrial Neoplasms; Female; Follow-Up Studies; Humans; Indocyanine Green; Middle Aged; Prognosis; Radiopharmaceuticals; Retrospective Studies; Rosaniline Dyes; Sentinel Lymph Node; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid; Uterine Cervical Neoplasms

(99)TC combined with blue-dye mapping is considered the best sentinel lymph node (SLN) mapping technique in cervical cancer. Indocyanine green (ICG) with near infrared fluorescence imaging has been introduced as a new methodology for SLN mapping. The aim of this study was to compare these two techniques in the laparoscopic treatment of cervical cancer.. Medical records of patients undergoing laparoscopic SLN mapping for cervical cancer with either (99)Tc and patent blue dye (Group 1) or ICG (Group 2) from April 2008 until August 2012 were reviewed. Sensitivity, specificity, and overall and bilateral detection rates were calculated and compared.. Fifty-eight patients were included in the study-36 patients in Group 1 and 22 patients in Group 2. Median tumor diameter was 25 and 29 mm, and mean SLN count was 2.1 and 3.7, for Groups 1 and 2, respectively. Mean non-SLN (NSLN) count was 39 for both groups. SLNs were ninefold more likely to be affected by metastatic disease compared with NSLNs (p < 0.005). Sensitivity and specificity were both 100 %. Overall detection rates were 83 and 95.5 % (p = nonsignificant), and bilateral detection rates were 61 and 95.5 % (p < 0.005), for Groups 1 and 2, respectively. In 75 % of cases, SLNs were located along the external or internal iliac nodal basins.. ICG SLN mapping in cervical cancer provides high overall and bilateral detection rates that compare favorably with the current standard of care.

Topics: Adenocarcinoma; Adult; Carcinoma, Squamous Cell; Coloring Agents; Female; Follow-Up Studies; Humans; Indocyanine Green; Laparoscopy; Lymph Nodes; Lymphatic Metastasis; Middle Aged; Neoplasm Staging; Optical Imaging; Prognosis; Prospective Studies; Radiopharmaceuticals; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid; Uterine Cervical Neoplasms

Preoperative injection of radiocolloid before a sentinel lymph node (SLN) biopsy is painful for patients with breast cancer. Injection after anesthesia eliminates this discomfort but allows less time for radiocolloid migration. Our goal was to validate the efficacy of intraoperative injection.. In this retrospective study of prospectively collected data, patients underwent periareolar dermal injection of technetium sulfur colloid. Patients in the preoperative injection (PO) group were injected by radiologists in the breast imaging center. Patients in the intraoperative injection (IO) group were injected by surgeons after induction of anesthesia. Consecutive cases were evaluated for radioactive "hotspots," time elapsed before incision, number of SLNs removed, number of positive SLNs, and percentage of positive biopsies.. Two hundred fourteen breasts were evaluated (PO = 102; IO = 112). The mean time from injection to incision was significantly shorter by 107 minutes for the IO group. There were no differences in the percentage of positive biopsies (PO: 20.6%; IO: 19.6%; P = 0.863), the number of SLNs removed (PO: 3.3; IO: 3.0; P = 0.091), or the number of positive SLNs (PO: 1.4; IO: 1.4; P = 0.657).. There are no significant differences in the principal results of SLN biopsy between PO and IO injection methods. Dermal radiocolloid injection after induction of anesthesia seems to be an oncologically sound procedure and may be a preferable technique.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Carcinoma, Lobular; Female; Humans; Intraoperative Period; Lymph Nodes; Middle Aged; Neoplasm Invasiveness; Preoperative Care; Prognosis; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid

To determine the patterns of lymphatic drainage from primary vaginal cancers utilizing lymphoscintigraphy and to determine if this clinical information would affect treatment planning.. For women with newly diagnosed vaginal cancer, pretreatment lymphatic mapping and sentinel lymph node identification were performed using lymphoscintigraphy. In patients who underwent surgery, sentinel lymph nodes were identified intraoperatively using radiocolloid and patent blue dye. The impact of pretreatment lymphoscintigraphy findings on radiation planning in women who received radiation as initial treatment was noted.. Fourteen women were enrolled during the study period. At least 1 sentinel lymph node was identified on pretreatment lymphoscintigraphy in 11 patients (79%). The median number of sentinel nodes found per patient was 2, and bilateral sentinel nodes were found in 6 (55%) of the 11 patients with sentinel nodes identified. Among these 11 patients, 5 (45%) had sentinel nodes identified in the groin only, 4 (36%) had sentinel nodes identified in the pelvis only, and 2 (18%) had sentinel nodes identified in both the groin and the pelvis. No relationship was observed between sentinel lymph node location and primary tumor histologic subtype or location. Three (33%) of the 9 women treated initially with radiation therapy had their radiation field altered as a result of the lymphoscintigraphy findings.. In women with vaginal cancer, lymphatic drainage from the primary lesion does not always follow the lymphatic channels that would have been predicted anatomically. The addition of lymphoscintigraphy to the pretreatment evaluation for women with vaginal cancer may significantly improve comprehensive treatment planning.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Humans; Lymph Nodes; Lymphatic Metastasis; Melanoma; Middle Aged; Pelvis; Predictive Value of Tests; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid; Vaginal Neoplasms

Sentinel lymph node (SN) biopsy based on dual labeling with blue dye and radiocolloid can reliably determine lymph node status in early-stage cervical cancer, but few data are available on its accuracy in more advanced disease. We examined the influence of tumor stage on the accuracy of SN biopsy in patients with cervical cancer.. Between July 2001 and June 2004, 33 patients (mean age 52 years) with early-stage or locally advanced cervical cancer underwent laparoscopic SN biopsy based on dual labeling with patent blue and radiocolloid. Patients with early-stage cervical cancer (stages IA and IB1, 23 patients) underwent complete laparoscopic pelvic lymphadenectomy after the SN procedure. Patients with locally advanced cervical cancer (stage IB2, IIA or IIB, 10 patients) underwent laparoscopic pelvic and para-aortic lymphadenectomy after SN biopsy and prior neoadjuvant concomitant chemoradiotherapy. The SN identification rates and false-negative rates of patients with early-stage and locally advanced disease were compared.. The mean numbers of SNs identified per patient with early-stage and locally advanced cervical cancer were 2.3 (range 0-4) and 1.9 (range 0-4), respectively. SNs were identified in 86.9% (20/23) of patients with early-stage disease and in 80% (8/10) of patients with locally advanced disease. When analyzed according to the side of dissection, the identification rate was lower, especially in the patients with locally advanced disease (55% compared with 67.4%). The false-negative rate per patient was zero in early-stage disease and 20% (1/5) in locally advanced disease (no significant difference). When the side of dissection was taken into account, the false-negative rate improved to 42.9% (3/7) in patients with locally advanced disease and remained at zero in early-stage disease (P=0.038). Isolated blue dye was taken up in 53.3% of SNs in patients with locally advanced disease, compared with only 6.4% in patients with early-stage disease.. This study suggests that the SN biopsy technique with dual labeling is less accurate in locally advanced cervical cancer than in early-stage cervical cancer.

Topics: Adenocarcinoma; Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; False Negative Reactions; Female; Humans; Laparoscopy; Lymph Node Excision; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Radionuclide Imaging; Radiopharmaceuticals; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid; Uterine Cervical Neoplasms

We present a case of unsuspected gastric carcinoma discovered as a result of abnormalities seen on a sulfur colloid gastric-emptying study. Considered a functional or physiological analysis, often relatively little attention is given to the morphology of the stomach except for the purpose of drawing a region of interest. This case, in which the images suggested a space-occupying lesion(s), emphasizes the importance of careful examination for "pathoanatomy" as well as pathophysiology in functional imaging.

Topics: Adenocarcinoma; Aged; Diagnosis, Differential; Female; Gastric Emptying; Gastroparesis; Humans; Radionuclide Imaging; Radiopharmaceuticals; Stomach Neoplasms; Technetium Tc 99m Sulfur Colloid

This study was undertaken to assess the feasibility of lymphoscintigraphy of the gastric cardia and to identify the incidence of paraesophageal lymphatic drainage, precluding total gastrectomy with esophagojejunostomy as a potentially curative therapy for gastric cardia cancer.. Ten patients scheduled for esophagectomy with high-grade dysplasia or with esophageal cancer at least 3 cm above the esophagogastric junction were enrolled in this study. Preoperatively, 111 MBq of(99m)Tc-labeled nanocolloid (n = 5) or sulfur colloid (n = 5) were injected into the submucosa of the tumor-free cardia. Subsequently, lymphoscintigraphy in combination with CT was obtained. Locoregional lymph node stations were measured for radioactivity by a gamma-probe intraoperatively and ex vivo in the resection specimen.. In each patient, at least 1 radioactive lymph node station was detected. In total, 42 radioactive lymph node stations were detected by gamma-probe. Of those 42 areas, 38 (90%) were visible at preoperative lymphoscintigraphy. In the group of 5 patients in whom nanocolloid was used, a median of 2 (range, 1-4) node stations per patient was identified, whereas when sulfur colloid was administered a median of 6 (range, 4-8) active lymph node stations per patient could be detected (P < 0.002). Paraesophageal drainage was identified in 1 patient.. Lymphoscintigraphy of the gastric cardia is feasible and can accurately determine the location of radioactive lymph nodes. Early paraesophageal lymphatic drainage is rare.

Topics: Adenocarcinoma; Carcinoma, Squamous Cell; Cardia; Coloring Agents; Esophageal Neoplasms; Esophagectomy; Feasibility Studies; Humans; Lymph Nodes; Lymphoscintigraphy; Male; Middle Aged; Radiopharmaceuticals; Stomach Neoplasms; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid

Because of surveillance strategies in patients with known Barrett's esophagus, more patients with high-grade dysplasia or early cancer in the distal esophagus and at the esophagogastric junction are identified. The need for and extent of lymphadenectomy in such patients are controversial. The technique of sentinel lymph node dissection (SLND) to diagnose early lymphatic spread is applied increasingly in tumors of the gastrointestinal tract. The poorly defined lymphatic drainage of the esophagogastric junction has so far prevented many investigators from performing SLND in tumors of this anatomic region. We report the first results of SLND in Barrett's and cardia cancer. The preliminary experience indicates that the method is, even in this anatomical area, feasible and yields good results in early tumors. In advanced tumors, the method lacks sensitivity. Mapping should be done with blue dye and a radiocolloid. The concept of sentinel lymph node mapping and detection thus may open the door to individualized therapy for patients with high-grade dysplasia in a Barrett's esophagus or with early Barrett's and cardia cancer.

Topics: Adenocarcinoma; Algorithms; Barrett Esophagus; Cardia; Coloring Agents; Esophageal Neoplasms; Esophagectomy; Esophagogastric Junction; Humans; Lymph Nodes; Lymphatic Metastasis; Radionuclide Imaging; Radiopharmaceuticals; Rosaniline Dyes; Sensitivity and Specificity; Sentinel Lymph Node Biopsy; Stomach Neoplasms; Technetium Tc 99m Sulfur Colloid

Lymph node metastases are the most significant prognostic factor in localized non-small-cell lung cancer (NSCLC). Nodal micrometastases may not be detected with current standard histologic methods. We review our experience with intraoperative injection of radioisotope, the current state of the technique, and the experience of other groups with alternate methods and tracers.

Topics: Adenocarcinoma; Carcinoma, Non-Small-Cell Lung; Humans; Intraoperative Period; Lung Neoplasms; Radiopharmaceuticals; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid

The objective were to study the relevance of the subareolar injection for sentinel node [SN] detection in multiple foci breast cancer. Seventy-nine patients with infiltrative breast carcinoma (diagnosed pre-operatively by core biopsy) and a mean age of 55 (31-78) years were enrolled. All patients were free of previous homolateral surgery, chemotherapy, locoregional radiotherapy or prevalent axillary lymph node. Using four 0.1 ml injections of 1.8 MBq, the technetium-99m 100 nm filtered sulfur colloid was injected by subareolar way (group I) in 16 cases of radiologically cancer with multiple invasive foci and 31 cases of radiologically unifocal cancer, and by peritumoral way (group II) in 32 cases of radiologically unifocal cancer. Scintigrams were obtained 2 to 4 hours after the injections and radioactive nodes were detected peroperatively 18 hours after the injection by intraoperative detection probe. Individual removal of all radioactive nodes was followed by axillary dissection at levels I and II of Berg including Rotter area control. All sentinel nodes were submitted to standard histopathological analysis on serial sections at 500 mu intervals completed by immunohistochemistry for cytokeratin on negative SN. SN were detected by scintigrams in 85% and 88% of the cases of group I and group II respectively, but in 98% and 97% of the cases of respectively both groups by intraoperative probe. Group I was composed of 69% ductal, 22% lobular and 9% tubular carcinomas, and group II of 87% ductal, 10% lobular and 3% tubular carcinomas. Seven and 5 radiologically unifocal tumors were in fact with multiple invasive foci at histology in groups I and II respectively. The complete scintigraphic procedure permitted the detection of a mean number of 2.7 (1-7) SN in group I and 2.3 (1-4) in group II (NS). In group I, the SN were metastatic in 22 patients (48%), 15 of them with the metastases being restricted to the SN, whereas in group II, the SN were metastatic in 9 patients (28%), 5 of them with the positivity restricted to the SN. No false negative result (SN negative and other axillary nodes positive) was observed in group I and only one false negative result in group II which was related to a cancer with histological multiple invasive foci. Sensitivities were 100% and 90%, and negative predictive values were 100% and 95%, for groups I and II respectively. Subareolar injection of radiocolloid allows identification of SN in cases of unifocal and multiple cancer. Th

Topics: Adenocarcinoma; Adult; Aged; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Lobular; Female; Humans; Injections; Lymph Nodes; Middle Aged; Neoplasms, Multiple Primary; Nipples; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Sulfur Colloid

The authors present a case that demonstrates the continued high sensitivity of Tc-99m SC liver-spleen imaging for thoracic splenosis. A patient with profound weight loss, positive PPD and left upper lobe lung density on a chest radiograph was felt to have a strong clinical suspicion of a malignant pulmonary lesion. Two needle biopsies of the lesion were consistent with splenic tissue. Transbronchial biopsy of the right lower lobe lung revealed metastatic adenocarcinoma of an unknown origin. A Tc-99m SC liver-spleen scan of the abdomen and thorax indicated the lung density was consistent with thoracic splenosis.

Topics: Adenocarcinoma; Adult; Humans; Liver; Lung Diseases; Lung Neoplasms; Male; Neoplasms, Unknown Primary; Radionuclide Imaging; Sensitivity and Specificity; Spleen; Splenosis; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Effective intraperitoneal (IP) chemotherapy and colloidal radiation therapy depend on contact of the drugs with the entire peritoneal surface. Using technetium-99m sulfur colloid, one can evaluate the completeness of peritoneal fluid distribution. Forty-eight planar IP scans from 26 patients with gastrointestinal malignancies were reviewed and scan findings were correlated with the site of primary tumor, surgical findings, and the location of any residual disease. Of the 26 patients, 22 had undergone resection of the primary lesion prior to scanning. Scans typically demonstrated more activity in the upper and lower portions of the abdomen than in the midabdomen. Diminished uptake in the pelvis, right lower quadrant, and right upper quadrant was generally due to metastases. A tumor mass was identified as responsible in only one of eight patients with diminished or absent left upper quadrant activity. Knowledge of variability in patterns seen on IP scans is essential to rational guidance of IP chemotherapy and radiation therapy.

Topics: Adenocarcinoma; Adult; Aged; Digestive System Neoplasms; Female; Humans; Injections, Intraperitoneal; Male; Middle Aged; Neoplasm Recurrence, Local; Peritoneal Cavity; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Some forms of glycogen storage disease (GSD) primarily affect the liver, including types I, III, IV, VI, IX and 0. Scanning with Tc-99m sulfur colloid, while not being specific, does reveal some characteristic features. Most experience is with scanning in type I disease, though there are few reports in the literature. Six patients with type I, type III, type IV, and probably type VI disease are presented in this report. GSD should be considered in infants and young children presenting with hepatomegaly and abnormal liver-spleen scans. Sequential imaging is useful in following these patients. When focal defects are present, long term follow-up is indicated to detect hepatocellular adenocarcinoma.

Topics: Adenocarcinoma; Adolescent; Adult; Child, Preschool; Female; Follow-Up Studies; Glycogen Storage Disease; Glycogen Storage Disease Type I; Glycogen Storage Disease Type II; Glycogen Storage Disease Type III; Glycogen Storage Disease Type IV; Glycogen Storage Disease Type VI; Humans; Infant; Liver; Liver Neoplasms; Male; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid

Radionuclide peritoneoscintigraphy has been used prior to chromic phosphate P-32 (P-32CP) intraperitoneal therapy to assure proper placement of the catheter in the peritoneal cavity, to exclude loculation, and to predict inadequate distribution of P-32CP. This is a case report of the detection of a peritoneal catheter improperly placed into the bowel lumen by pretherapy radionuclide peritoneoscintigraphy, and this case demonstrates the distinguishing characteristics of the radiocolloid distribution secondary to an intraluminal injection relative to an intraperitoneal injection.

Topics: Adenocarcinoma; Brachytherapy; Catheterization; Chromium; Chromium Compounds; Colonic Neoplasms; Female; Humans; Middle Aged; Peritoneal Cavity; Peritoneal Neoplasms; Phosphates; Phosphorus Radioisotopes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

A retrospective analysis of 104 chest radionuclide angiography (CRNA) studies establishes the utility of this procedure in the evaluation of pulmonary malignancies and benign masses. Remarkable abnormalities in the perfusion of the lungs were identified in 36 (58%) of 62 cases that were not predictably normal or predictably abnormal form the clinical setting. While 60 of these 62 cases involved malignancy being evaluated for metastases, only 21 (34%) had metastases identified by radionuclide bone or liver-spleen scintigraphy. In addition to diagnosis of superior vena cava obstruction, the CRNA may have a more frequent application as an adjunct to routine scintigraphic studies directed to the identification of metastatic disease.

Topics: Adenocarcinoma; Aged; Carcinoma, Squamous Cell; Diphosphonates; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Vena Cava, Superior

The authors present their experience with the radionuclide esophagogram. Cases illustrating achalasia, diffuse esophageal spasm, nutcracker esophagus, oculopharyngeal muscular dystrophy, reflux esophagitis, gastroesophageal reflux, Barrett's esophagus, hiatal hernias, pharyngoesophageal diverticulum, and malignant tumors of the esophagus are included. The radionuclide esophagogram proved to be a useful procedure in the diagnosis and follow-up of many esophageal diseases.

Topics: Adenocarcinoma; Adult; Aged; Barrett Esophagus; Deglutition Disorders; Diverticulum, Esophageal; Esophageal Achalasia; Esophageal Diseases; Esophageal Neoplasms; Esophagitis, Peptic; Female; Gastroesophageal Reflux; Hernia, Hiatal; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Radionuclide Imaging; Reference Values; Spasm; Stomach Neoplasms; Technetium Tc 99m Sulfur Colloid

Correlation of a chest roentgenogram and a radionuclide scan facilitated the interpretation of a liver scan with a defect in the dome that was due to an extrinsic compression and photon attenuation by a metastatic tumor in the right lung base.

Topics: Adenocarcinoma; Aged; Colonic Neoplasms; False Positive Reactions; Humans; Liver; Lung Neoplasms; Radiography; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Adenocarcinoma; Aged; Humans; Imino Acids; Liver Neoplasms; Lung Neoplasms; Male; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Sulfur Colloid

Topics: Adenocarcinoma; Antibodies, Neoplasm; Carcinoembryonic Antigen; Female; Humans; Iodine Radioisotopes; Isotope Labeling; Middle Aged; Radioimmunoassay; Serum Albumin; Sigmoid Neoplasms; Sulfur; Technetium; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid

Metastatic involvement of the spleen is uncommon. Lymphoma is the most common cause of primary and secondary malignant lesions of the spleen, whereas splenic metastases from carcinoma are rare and usually occur in a setting of concomitant carcinomatosis with melanoma, breast, ovary and lung accounting for the principal primary tumors. We report a case of an isolated, focal splenic defect demonstrated by Tc-99m-sulfur colloid scintigraphy which was the only visual evidence of metastatic adenocarcinoma of the colon. To our knowledge this unusual cause of a focal splenic defect on liver-spleen scintigraphy has not been previously described.

Topics: Adenocarcinoma; Aged; Colonic Neoplasms; Humans; Liver; Male; Radionuclide Imaging; Spleen; Splenic Neoplasms; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid