technetium-tc-99m-sulfur-colloid and Lung-Diseases

The major role of nuclear medicine in clinical oncology is in tumor imaging, which includes evaluating specific organs or the entire body for the presence of tumor. Nuclear medicine studies have been used clinically in the initial evaluation of the tumor extent and in the subsequent management of the cancer patient to assess response to treatment, to detect early relapse, and to assist in making decisions concerning follow-up treatment. Technetium-99m macroaggregated albumin perfusion study for intraarterial chemotherapy has been helpful in monitoring the catheter tip, providing a map of regional perfusion at the capillary level (tumor vascularity), evaluating the degree of arteriovenous shunt in tumor bed, and optimizing division of the dose of chemotherapeutic agent when bilateral arterial catheters are used. Quantitative and serial radionuclide angiocardiography has been useful in assessing doxorubicin (Adriamycin, Adria Laboratories, Columbus, Ohio) toxicity, and 67Ga-citrate imaging has been used to monitor chemotherapy effect on lungs and kidneys. Radionuclide venography can demonstrate suspected thrombus, and the delineation of the vascular anatomy also allows proper placement of another catheter for continuous effective chemotherapy. Serial bone scans have been the primary modality to assess the response of bone metastasis to systemic therapy in breast cancer patients, and nuclear hepatic imaging may show tumor response, hepatocellular dysfunction, and cholecystitis related to chemotherapeutic agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Antineoplastic Agents; Bone and Bones; Bone Neoplasms; Chemotherapy, Cancer, Regional Perfusion; Doxorubicin; Gallium Radioisotopes; Heart Failure; Humans; Injections, Intra-Arterial; Kidney Diseases; Liver; Liver Diseases; Lung; Lung Diseases; Magnetic Resonance Spectroscopy; Neoplasms; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Thrombophlebitis; Tomography, Emission-Computed

Noonan syndrome is characterised by a Turner-like phenotype and a normal karyotype. Although it is reported to be associated with abnormalities of the lymphatic system, involvement of the pulmonary lymphatics is rare. We present a case of Noonan syndrome where a whole body scintigraphy revealed lymphangiectasia of the lower extremities, abdomen and lungs.

Topics: Abdomen; Adolescent; Female; Humans; Lung Diseases; Lymphangiectasis; Noonan Syndrome; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Purpose. We wanted to demonstrate the utility of the radionuclide salivagram in assessing children whose underlying medical problems suggest that aspiration of oral contents is a factor contributing to otherwise unexplained lung disease or recurrent pneumonias. Materials and methods. Following sublingual administration of 300 μCi (11.1 MBq) of technetium-99m sulfur colloid in a drop of saline, serial images were obtained for 60 min and evaluated for entrance of tracer into the major airways and lung parenchyma. Thirty-four studies were performed on 31 patients (age: 3 weeks - 16.7 years, mean 5.5 years) with recurrent pneumonias or unexplained lung disease. All had medical conditions, most frequently neurological, predisposing to aspiration. Results. Pulmonary aspiration was detected in eight patients. All positive studies demonstrated aspirated tracer distal to the tracheal bifurcation, either in bronchi or in bronchi and lung parenchyma. Aspiration was bilateral in six cases. Clearance of aspirated tracer was noted in one patient. Conclusion. The salivagram is an effective tool for demonstrating aspiration of oral contents and the level to which aspirated fluid penetrates the tracheobronchial tree. Additionally, by allowing for the evaluation of clearance of aspirated tracer, the salivagram may provide information on the status of airway-protective mechanisms.

Topics: Bronchi; Child, Preschool; Female; Humans; Lung Diseases; Male; Pneumonia, Aspiration; Radionuclide Imaging; Risk Factors; Saliva; Technetium Tc 99m Sulfur Colloid; Trachea

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

Since the scintillation camera enables us to include lower thorax in the views obtained during Tc-99m colloid imaging of the liver and spleen, intrathoracic pathology may be identified as relatively cold or hot areas in the thoracic cavity. Eighteen patients who underwent Tc-99m sulfur colloid imaging during a one-year period were found to have intrathoracic pathology demonstrated either as photopenic areas or as areas of increased radioactivity. These patients' clinical data and the results of other diagnostic modalities, including autopsy, were correlated with the Tc-99m images. The intrathoracic disease processes recognized were bacteremia, two cases; pleural effusion, two cases; lung pathology, one case; and cardiomegaly, 13 cases. With the Exception of two patients with bacteremia who had substantial radiocolloid sequestration by the lung, all the other patients had hepatic dysfunction. The presence of compromised hepatic function allows the visualization of intrathoracic abnormalities: photopenia suggesting pleural fluid collection or an enlarged cardiac silhouette (either photopenia or increased radioactivity occupying a large space in the anterior view to yield cardiothoracic ratio of greater than 50%). Therefore, Tc-99m sulfur during colloid liver-spleen imaging, patients with hepatic dysfunction may incidentally demonstrate intrathoracic pathology, especially cardiomegaly.

Topics: Aged; Cardiomegaly; Humans; Liver; Lung Diseases; Male; Middle Aged; Pleural Effusion; Radionuclide Imaging; Retrospective Studies; Sepsis; Spleen; Technetium Tc 99m Sulfur Colloid

For several years, radioaerosols have been successfully used to provide detailed images of regional ventilation to aid in the differential diagnosis of pulmonary embolism. It has been widely advocated that the ventilation images should follow the perfusion scan and that the amount of aerosol deposited in the patient's lungs should be three times greater than the perfusion dose. We employed an alternative approach which avoided the deposition of an unpredictable amount of aerosol in individual patients. The aerosol study was performed first, and the activity of the microspheres used for the perfusion images was then tailored to the actual amount of aerosol which the patient had retained. This allowed a microsphere/aerosol activity ratio of 10:1 to be readily achieved, thus successfully masking the ventilation pattern by the perfusion activity. The faster biological clearance of 99mTc-DTPA aerosol from the lung fields, as compared to 99mTc-sulphur-colloid aerosol, allowed higher initial activities to be deposited in the lungs, thus enabling a high-resolution collimator to be used. When the perfusion study was delayed by 1 h (one effective half-life for the 99mTc-DTPA aerosol), it was not necessary to increase the perfusion activity required to mask the ventilation image.

Topics: Aerosols; Humans; Lung Diseases; Methods; Microspheres; Pentetic Acid; Radionuclide Imaging; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid; Ventilation-Perfusion Ratio

Topics: Adult; Erythrocytes; Female; Hemorrhage; Humans; Lung; Lung Diseases; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Pulmonary hemorrhage, whether in the form of hemoptysis or bleeding into the pleural space, may be a life threatening problem. While fiberoptic bronchoscopy and selective bronchial and intercostal angiography are the major diagnostic modalities, these techniques are not without risks. Two patients are described-one with massive hemoptysis from a bronchogenic carcinoma; another with pleural bleeding from a torn intercostal artery-in whom Tc-99m-sulfur colloid scintigraphy accurately located the source of hemorrhage. We conclude that Tc-99m-sulfur colloid scintigraphy may be a helpful noninvasive method to increase the sensitivity and specificity of fiberoptic bronchoscopy and bronchial angiography in patients with massive pulmonary bleeding.

Topics: Adult; Angiography; Bronchoscopy; Carcinoma, Bronchogenic; Diagnosis, Differential; Fiber Optic Technology; Hemoptysis; Hemorrhage; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Pleura; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid