technetium-tc-99m-tetrofosmin and Head-and-Neck-Neoplasms

99mTc tetrofosmin scintimammography has been shown to be an accurate diagnostic test in patients with a symptomatic breast lesion and for whom a non-diagnostic mammogram has been obtained. Since a physical examination and conventional imaging modalities have their limitations in the detection of recurrent breast cancer, and survival is related to the extent of recurrent disease, complementary imaging modalities are warranted.. To evaluate the role of 99mTc tetrofosmin scintimammography in detecting the recurrence of loco-regional breast cancer.. Fifty-four patients underwent 55 scintimammography studies because either there were clinical indications of breast metastases, or there was a recurrence of metastases in the chest wall, and/or an evaluation of axillary, parasternal, supraclavicular and/or infraclavicular lymph node metastases was required. Planar breast imaging was performed 10 min after intravenous injection of 700 MBq 99mTc tetrofosmin.. 99mTc tetrofosmin scintimammography was diagnostic in 50 of the 55 studies. An unknown lung metastasis was detected in one patient, and an unknown bone metastasis of the sternum was detected in another. Tumour involvement remained undetected in one neck node metastasis. Three patients had false positive scintimammography results, with 99mTc tetrofosmin uptake in an axillary, infraclavicular and parasternal lymph node, respectively. A fourth patient showed 99mTc tetrofosmin uptake in the scar, which appeared to be an inflammatory lesion, proven by a histopathological biopsy and 1 year clinical follow-up.. 99mTc tetrofosmin scintimammography accurately detected 100% of the local recurrences independently of the extent of the preceding surgical intervention. The sensitivity and specificity of the technique for the detection of regional recurrent disease were 93% and 90%, respectively. These results are substantially higher than those of other imaging modalities.

Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Breast Neoplasms; False Positive Reactions; Female; Head and Neck Neoplasms; Humans; Injections, Intravenous; Lung Neoplasms; Lymph Nodes; Lymphatic Metastasis; Mastectomy; Middle Aged; Neoplasm Recurrence, Local; Organophosphorus Compounds; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Thoracic Wall

The effectiveness of 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) and technetium-99m tetrofosmin (Tc-99m TF) single photon emission computed tomography (SPECT) of neck and chest was evaluated to detect metastatic lesions in well-differentiated thyroid carcinoma after nearly total thyroidectomy and radioiodine (I-131) treatment who present with elevated serum human thyroglobulin levels but negative I-131 whole body scan.. Twenty-three patients with differentiated thyroid carcinoma who underwent nearly total thyroidectomy and I-131 treatments were included in this study.. All of the 23 patients had negative I-131 whole body scan and elevated human thyroglobulin levels under thyroid-stimulating hormone stimulation. Metastatic lesions were detected by FDG-PET in 20 patients, while Tc-99m TF SPECT revealed metastatic lesions in only 11 of the 20 patients. Both FDG-PET and Tc-99m TF SPECT failed to demonstrate miliary pulmonary metastases in two of the remaining three patients. The other patient did not show any lesion on FDG-PET, Tc-99m TF SPECT, chest computed tomography, or other imaging techniques.. This study demonstrated that FDG-PET is more sensitive than Tc-99m TF SPECT to detect metastatic lesions in differentiated thyroid carcinoma with elevated human thyroglobulin but negative I-131 whole body scan. However, miliary pulmonary metastases could be missed by the both techniques.

Topics: Adult; Aged; Carcinoma, Papillary, Follicular; Female; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Iodine Radioisotopes; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Sensitivity and Specificity; Thyroid Neoplasms; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon

Topics: Adult; Carcinoma, Papillary; Head and Neck Neoplasms; Humans; Male; Organophosphorus Compounds; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Thyroid Neoplasms; Thyroidectomy