technetium-tc-99m-sulfur-colloid and Peritoneal-Neoplasms

Intraperitoneal installation of chemotherapy through a Mediport implanted subcutaneously in the abdominal wall is used currently for treatment of peritoneal metastases from ovarian, gastric and colonic carcinoma. There is a variable incidence of complications due to the procedure reported in the literature. The main predisposing factor for these complications is the inhomogeneous distribution of the chemotherapeutic drugs within the peritoneal cavity. We report an unusual case of a rectosigmoid fistula that developed 6 wk following the insertion of a Bardport subcutaneously in the abdominal wall for intraperitoneal therapy. The fistula was clearly demonstrated by dynamic scintigraphic peritoneography. This is a new modification of scintigraphic peritoneography as practiced routinely. We endorse the previous recommendation that scintigraphic peritoneography be performed before every intraperitoneal installation of a chemotherapeutic drug or radiopharmaceutical to ensure the homogeneous distribution of the drugs and to prevent complications.

Topics: Aged; Antineoplastic Agents; Catheters, Indwelling; Female; Humans; Intestinal Fistula; Peritoneal Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Rectal Fistula; Sigmoid Diseases; Technetium Tc 99m Sulfur Colloid; Time Factors

Scintigraphic image of the superior rectal and inferior mesenteric lymph nodes 7-8 cm up from the anus was obtained by presacral administration of finely divided 99mTc-colloid (close to the posterior rectal wall). The results of radiometry of the lymph nodes dissected at radical operation for rectal cancer have shown that due to the above method the radioactive indicator is accumulated in these groups of lymph nodes. Several variants of a scintigraphic picture were defined on the basis of analysis of scintigrams of 23 patients with extrarectal tumors and nontumorous diseases and 40 rectal cancer patients. Evaluation of the lymphoscintigraphy results compared with the morphological findings of the lymph nodes dissected at operation in 32 rectal cancer patients, has shown that the overall accuracy of the above method is 0.81, specificity--0.63, sensitivity--1.0.

Topics: Adult; Aged; Female; Humans; Lymphatic Metastasis; Male; Mesentery; Middle Aged; Peritoneal Neoplasms; Radionuclide Imaging; Rectal Neoplasms; Technetium Tc 99m Sulfur Colloid

We present one case of peritoneal splenosis, which was not confirmed by the splenic scintiscan with 99mTc-sulphur colloid, but whose diagnosis, carried out during a second scintiscan with 99mTc-heat-damaged RBC, was confirmed by laparotomy and histology. This case confirms that, for the diagnosis of splenosis, heat-damaged RBC scintigraphy must be used rather than either sulphur colloid scintigraphy or computed-tomography.

Topics: Choristoma; Erythrocytes; Female; Hot Temperature; Humans; Peritoneal Neoplasms; Radionuclide Imaging; Spleen; Technetium; 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