technetium-tc-99m-sulfur-colloid and Genital-Neoplasms--Female

We investigated the prognostic value of qualitative lymphoscintigraphy in gynecological cancer-related lymphedema, which is a common complication after treatment.. All 152 patients underwent (99m) Tc tin-colloid lymphoscintigraphy before complex decongestive therapy (CDT). We analyzed the uptake patterns of the inguinal lymph nodes, main lymphatic vessel and collateral lymphatic vessels, as well as dermal back flow. We compared these lymphoscintigraphic findings and other clinical variables between good and poor therapeutic responders using Pearson's Chi-squared test, Fisher's exact test and multiple logistic regression analysis.. Eighty-nine patients (58.6%) had a poor therapeutic response to CDT. In univariate analysis, there were significant differences between good and poor responders in clinical stage (P < 0.001), therapy compliance (P < 0.001), main lymphatic vessel uptake pattern (P < 0.01), collateral lymphatic vessel uptake pattern (P < 0.01) and severity of dermal back flow (P < 0.001). After multivariate analysis, only severity of dermal back flow (P < 0.005), clinical stage (P < 0.05) and therapy compliance (P < 0.001) were found to be independent predictors of therapeutic response.. Lymphoscintigraphy may be useful to predict the outcome of patients with gynecological cancer-related lymphedema undergoing CDT along with clinical stage and compliance.

Topics: Adult; Aged; Female; Follow-Up Studies; Genital Neoplasms, Female; Humans; Lymphatic Vessels; Lymphedema; Lymphoscintigraphy; Middle Aged; Neoplasm Staging; Prognosis; Radiopharmaceuticals; Technetium Tc 99m Sulfur Colloid

In a retrospective study the diagnostic validity of sonography (US), computer-tomography (CT), scintigraphy (SC) and serum alkaline phosphatase (AP) in the detection of liver metastases was evaluated in 929 patients with malignant tumors: ovary (n = 367), mamma (n = 189), endometrium (n = 181), cervix (n = 162), fallopian tube (n = 10), vulva (n = 20). Definitive diagnosis was confirmed by autopsy (n = 51), surgical intervention (n = 297) or follow-up (n = 581). Specificity, sensitivity and overall accuracy of the different methods in the indication of liver metastasis were as follows: CT (n = 58) 81%, 98%, 93%, US (n = 929) 70%, 94%, 90%, SC (n = 512) 66%, 85%, 81%, AP (n = 325) 68%, 93%, 87%. In the last examination period, US and CT reached comparable results. In view of efficiency, AP and US would appear suitable for routine control in gynecological malignancies.

Topics: Alanine Transaminase; Alkaline Phosphatase; Aspartate Aminotransferases; Diagnostic Imaging; Female; Genital Neoplasms, Female; Humans; Liver Function Tests; Liver Neoplasms; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

Between 1978 and 1980, 33 patients with cervical cancer, 40 patients with ovarian cancer, and 28 patients with uterine cancer underwent clinical diagnostic staging. Fifty-four patients had bone scans, and 101 patients received liver scans as a part of their staging work-up. No positive bone scan results were found. Eight of 33 patients with Stage IV disease had positive liver scan results consistent with hepatic metastases. Only 1 of 69 patients with Stage I-III disease had a positive test for metastases. While these numbers are small, the authors conclude that bone and liver scanning in asymptomatic patients with early stage gynecologic cancers may not be warranted as staging procedures.

Topics: Bone and Bones; Bone Neoplasms; Diphosphonates; Female; Genital Neoplasms, Female; Humans; Liver; Liver Neoplasms; Neoplasm Staging; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Time Factors