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Iliopelvic lymphoscintigraphy as a predictor of early metastatic disease in patients with prostate carcinoma.

Fifty-one patients had iliopelvic lymphoscintigraphy (IPL) as part of the initial assessment of newly diagnosed prostate carcinoma over a 3-year period. Investigations other than IPL showed that all patients had disease confined to the prostate, and they received radiotherapy to the prostate and regional pelvic lymph nodes. Patients with complete absence of activity in an iliac chain on IPL were excluded from the analysis because that finding could have resulted from tumor replacement or a failed injection. Of the remaining 41 patients, 12 had abnormal scintigrams, and 6 (50%) had recurrence within a mean 15-month follow-up period. Of 29 patients with normal scintigrams, 26 (90%) remain disease free over an average 27-month follow-up period.

Aged↗

Imaging of regional spread of breast cancer by internal mammary lymphoscintigraphy, CT, and MRI.

Forty women with breast cancer underwent imaging by internal mammary lymphoscintigraphy (IMLS), which was correlated with the results of CT and MRI of the chest. IMLS was performed and interpreted using the previously described methods of Ege. It identified 22 instances of ipsilateral internal mammary nodal involvement, none of which corresponded to cases of abnormally enlarged (diameter greater than 1.0 cm) internal mammary nodes on CT and/or MRI. Positive IMLS was associated with axillary nodal metastases in 15 out of 22 instances. The authors conclude that IMLS provides information on regional nodal spread of breast cancer that is not available with either CT/MRI imaging or axillary biopsy.

Antimony↗

Tc-99m isonitrile uptake in a brain metastatic lesion. Comparison with Tc-99m DTPA using planar and SPECT imaging.

Tc-99m isonitrile uptake in a metastatic brain tumor is demonstrated using planar and SPECT imaging. Comparison with Tc-99m DTPA shows a different distribution pattern and uptake intensity, suggesting a different mechanism for both tracers. It is possible that Tc-99m CPI could reflect metabolic activity of the tumor cells and might be useful to evaluate the grade of malignancy as well as the recurrence of brain tumors.

Brain Neoplasms↗

Lymphoscintigraphy. A reliable test for the diagnosis of lymphedema.

The efficacy of lymphoscintigraphy in the diagnosis of lymphedema was evaluated in 17 patients (total of 20 extremities). Final diagnoses were: three extremities with primary lymphedema, eight with secondary lymphedema, and nine with edema due to other causes. Qualitative interpretation of image patterns was reliable in differentiating lymphedema from edema of other origins (sensitivity 73%, specificity 100%). There were eight true-positive, nine true-negative, no false-positive, and three false-negative extremities. The three false-negative results occurred in extremities that were not imaged within the first hour. Lymphoscintigraphy is a reliable, objective, and noninvasive means of supporting the diagnosis of lymphedema, and lends itself more readily to repeated studies for follow-up than other available tests.

Adult↗

The use of CT and scintigraphy in diagnosing a cystic ameloblastoma of the jaw.

The results of CT and bone scintigraphy of eight patients with a histologically proven cystic ameloblastoma of the jaw are reviewed. CT imaging revealed unilocular and multilocular cystic lesions with well-defined thin cystic borders in all patients. CT also detected increased density in the bone marrow adjacent to the cystic radiolucent lesion, suggesting that the ameloblastoma had spread into the cancellous bone. Further, nuclear bone scans showed a doughnut-shaped pattern in all cases and radioactivity beyond the cystic wall, indicating intramedullary extension of the ameloblastoma. The use of these two modalities was found to be complementary in delineating the full nature and extent of the pathologic lesion.

Adult↗

Difference between splenic volume measured at necropsy and that measured in vivo by radionuclide tomography.

Reference values for splenic volume used in this study are based on necropsy measurements made in 1970. Because the volumes (measured by radionuclide tomography) seemed to be consistently greater than the necropsy values, the splenic volume in 35 healthy male volunteers ranging in age from 18-30 years (median age, 21 years) was studied. Their mean (SD) splenic volume was 281 (73) ml compared with 138 (34) ml in the reference group. The mean splenic volume in healthy volunteers seems to be significantly greater than in cadavers, and these results suggest that reference range for splenic volume in vivo should be revised.

Adult↗

Lymphatic drainage from peri-umbilical skin to internal mammary nodes.

While performing lymphoscintigraphy to define draining lymph node groups and sentinel nodes in patients with melanoma, the authors have discovered a new lymphatic channel in two patients with tumors in the peri-umbilical area. This channel passes over the right costal margin to an interval node before passing toward the midline, where it passes through the chest wall to reach the internal mammary lymph node chain. Appreciating the possible presence of this channel in patients with periumbilical lesions has important implications for the surgical management and follow-up of these patients.

Antimony↗

Tc-99m stannous colloid-labeled leukocyte scintigraphy in the evaluation of the painful arthroplasty.

The aim of this study was to evaluate the utility of scintigraphy using leukocytes labeled with Tc-99m stannous colloid in the assessment of painful arthroplasties. The results of three-phase bone scintigraphy and imaging with Tc-99m-labeled leukocytes in 40 patients with painful joint prostheses, requiring the exclusion of infection are reported. Results were compared with microbiologic culture and/or long-term clinical review. Bone scintigraphy had a sensitivity of 100%, a specificity of 64%, and a diagnostic accuracy of 73% in detecting prosthetic infection. Tc-99m-labeled leukocytes yielded a sensitivity of 70%, a specificity of 100%, and a diagnostic accuracy of 93%. Leukocyte scintigraphy improves the specificity of bone scintigraphy in the assessment of the painful prosthetic joint. A positive study is highly suggestive of infection and warrants appropriate treatment.

Adult↗

Liver hemangioma. A perioperative Tc-99m RBC SPECT correlation.

Scintigraphic diagnosis of a liver hemangioma may be difficult when its size approaches the spatial resolution of a gamma camera, and it may not be visualized on a Tc-99m tin-colloid liver SPECT study. The contribution of Tc-99m labeled RBC scintigraphy is shown in a patient with a liver hemangioma discovered during laparoscopic cholecystectomy for chronic cholecystitis. Despite negative CT, US, and Tc-99m tin-colloid SPECT of the liver, Tc-99m labeled RBC SPECT disclosed a focus of increased activity consistent with the hemangioma.

Colloids↗

Painful knee joint prostheses: evaluation for loosening by combined radionuclide arthrography and transmission imaging.

UNLABELLED: Interpretation of radionuclide arthrograms (RNA) of the knee after total knee joint replacement (TKR) may be difficult because of the lack of sufficient anatomic reference information. Additional transmission images may provide the necessary reference information required for correct interpretation of RNA of the knee. METHODS: Tc-99m tin colloid (20 MBq) RNA was combined with cobalt-57 transmission imaging in six patients with painful TKRs in whom loosening of the TKR was suspected. Knee surgery was then performed on these six cases. RESULTS: RNA correctly detected loosening of the tibial component in five of six cases, but did not detect loosening of the femoral component in any of three cases. CONCLUSION: RNA combined with transmission imaging is recommended for detection of loosening of the tibial component of a TKR. RNA may not be of value for detecting loosening of the femoral component.

Aged↗