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

The technique of sentinel lymph node (SLN) biopsy for melanoma provides accurate staging information because the histology of the SLN reflects the histology of the entire basin, particularly when the SLN is negative.. We combined two mapping techniques, one using vital blue dye and the other using radiolymphoscintigraphy with a hand-held gamma Neoprobe, to identify the SLN in 600 consecutive patients with stage I-II melanoma. The SLNs were examined using conventional histopathology and immunohistochemistry for S-100.. Eighty-three (13.9%) patients had micrometastatic disease in the SLNs. Thirty percent of patients with primary melanomas greater than 4.0 mm in thickness had positive SLNs, followed by 48 of 267 (18%) of patients with tumors between 1.5 mm and 4 mm, and 12 of 169 (7%) of those with lesions between 1.0 mm and 1.5 mm. No patient with a tumor less than 0.76 mm in thickness had a positive SLN. Sixty-four of the 83 SLN-positive patients consented to undergo complete lymph node dissection (CLND), and five of 64 (7.8%) of the CLNDs were positive. All patients with positive CLNDs had tumor thicknesses greater than 3.0 mm.. The rate of SLN-positive patients increases with increasing thickness of the melanoma. SLN-positive patients with primary lesions less than 1.5 mm in thickness may have disease confined to the SLN, thus rendering higher-level nodes free of disease, and may not require a CLND.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Child; Extremities; Female; Follow-Up Studies; Gamma Cameras; Head and Neck Neoplasms; Humans; Immunohistochemistry; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Melanoma; Middle Aged; Neoplasm Staging; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Rosaniline Dyes; S100 Proteins; Skin Neoplasms; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms

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

Thirteen patients with a history of confirmed liver carcinoma were given either I131 goat polyclonal or murine monoclonal antibodies against alpha-fetoprotein (AFP), and then scanned with a gamma camera. In order to reduce background, nontarget activity, especially in the liver, blood pool, and reticuloendothelial system, 99mTc imaging agents were used for tumor image enhancement by computer-assisted subtraction. A sensitivity of 91% for the primary site, 50% for the lungs (33% for the chest area), and 75% for the abdomen and pelvis was achieved, with a specificity of 100%, 94%, and 100% for these sites, respectively. The accuracy was determined to be 93% for the liver, 86% for the lungs (77% for the chest), and 85% for the abdominal and pelvic area, resulting in an overall accuracy rate for imaging primary and metastatic hepatocellular cancer of 84% (90% if bone metastases are excluded). In two of the 13 patients, lesions that had been missed by conventional liver scintigraphy and transmission computed tomography (CT) were first shown by radioimmunodetection (RAID).

Topics: Abdominal Neoplasms; Adult; alpha-Fetoproteins; Antibodies; Antibodies, Monoclonal; Carcinoma, Hepatocellular; Child, Preschool; Female; Hemangiosarcoma; Humans; Image Enhancement; Image Processing, Computer-Assisted; Liver Neoplasms; Male; Pelvic Neoplasms; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms

Topics: Bone Marrow; Humans; Iron Radioisotopes; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms