-
[show abstract]
[hide abstract]
ABSTRACT: Objective:67Ga scintigraphy has a well-documented role in nodal lymphoma for both disease staging and assessment of treatment response.
The objective of the present study was to examine the role of67Ga scintigraphy in diagnosis and assessment of treatment response, in patients with extranodal malignant lymphoma.Methods: Seventy-one patients with extranodal malignant lymphoma were studied. Whole body scans in all and SPECT scans in some selected
patients were performed 72 hours after injection of67Ga-citrate. The influence of tumor site, histological classification and tumor size on67Ga scintigraphy sensitivity was analyzed. Twenty-one of the seventy-one patients also had a second67Ga scintigraphy to assess response to treatment.Results: The overall67Ga scintigraphy sensitivity was 83.1% (59/71). The sensitivity was low in patients whose extranodal lymphoma occurred in skin
(0/3) and urinary bladder (0/1), as compared to other tumor sites. According to the histological classification of the lesion,
the sensitivity was lower in low-grade than in intermediate and high-grade lymphoma. According to the tumor size, the sensitivity
was low in lesions less than 2 cm in diameter than those more than 2 cm in diameter. The results changed from positive to
negative accumulation in 20 (95.2%) of the 21 patients who had67Ga scintigraphy to assess the response to treatment. These 20 patients showed a good clinical course.Conclusions: Although67Ga scintigraphy did not show positive accumulation in patients with skin and urinary bladder lymphoma, it was helpful to confirm
the diagnosis and to evaluate the therapeutic effect in most patients with extranodal malignant lymphoma.
Annals of Nuclear Medicine 04/2012; 17(8):657-662. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Objective: The purpose of this study was to evaluate the usefulness of201T1 scintigraphy in comparison with three-phase bone scintigraphy in the differentiation of residual/recurrent tumors from
post-therapeutic changes, in patients previously treated for bone and soft-tissue tumors.Methods: Thirty-five201T1 and three-phase bone scintigraphy scans were obtained for 30 patients with a history of bone or soft-tissue tumor who had
undergone chemotherapy, radiation therapy, tumor resection, or a combination of these treatments. The planar201Tl images were acquired 10 mins (early) and 2 hrs (delayed) after the intravenous injection of 111 MBq201Tl-chloride. Three-phase bone scintigraphy was performed using 740 MBq99mTc-HMDP at the same lesion site as for201T1 imaging. The blood flow images were obtained every 10 sec for 2 mins and were immediately followed by the blood pool image
after 5 mins. Three to 4 hrs later, bone images were obtained.201Tl and three-phase bone scintigraphies were correlated with the histopathologic findings and/or clinical follow-up of more
than 3 months.Results: Of the 35 cases, 15 were free of disease and 20 had residual or recurrent tumors. Of the 20 residual or recurrent cases,
all had true-positive201T1 early and delayed scans, while bone scintigraphy was true-positive on the blood flow, blood pool and bone images in 16,
18 and 12 cases, respectively.201T1 early and delayed images and99mTc-HMDP blood flow and blood pool images were false-positive in one patient. The histology of this false-positive case showed
the presence of lymph proliferative tissue.Conclusions: Although201Tl uptake after treatment does not always indicate recurrence,201T1 scintigraphy may still be more useful than three-phase bone scintigraphy in the follow-up of patients with bone and soft-tissue
tumors following therapy.
Annals of Nuclear Medicine 04/2012; 18(3):235-241. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We performed a retrospective study examining the prevalence and subtypes of pulmonary emphysema (PE) identified by computed tomography (CT) in females. We reviewed the records of 1,687 female subjects who had undergone CT. They were divided into the following 2 age groups:group A (<50 years) and group B (≥50 years). PE was diagnosed by the presence of low-attenuation areas using visual assessment (grades 0-3) on CT images. Two subtypes of PE were observed:centrilobular emphysema (CLE) and paraseptal emphysema (PSE). PE was divided into the following 3 categories:I (CLE or CLE-predominant);II (CLE and PSE of equal extent);and III (PSE or PSE-predominant). PE was found in 64 of 274 smokers (23.3%) and 54 of 1,413 non-smokers (3.8%). In smoking subjects, when grades 1 and 2 were grouped together as mild PE, the mean age for CT grade 3 (severe PE) was significantly higher than that for mild PE. In group A, category III predominated, whereas category I was more prevalent in group B, in both smoking and non-smoking subjects. A high incidence of PE was found in smoking subjects as compared with non-smoking subjects. PSE predominated in younger subjects, whereas CLE predominated in older subjects.
Acta medica Okayama 02/2011; 65(1):27-32. · 0.84 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We investigated a new technique for identifying the lung intersegmental line using infrared thoracoscopy with intravenous injection of indocyanine green.
This was an experimental animal study, and target segments were established preoperatively. Six adult beagle dogs underwent thoracotomy. After the corresponding pulmonary artery of the target segment had been ligated, indocyanine green was administered intravenously during infrared thoracoscopy. The lung was separated into 2 areas, white and blue, according to the blood flow on the monitor. We marked the visceral pleura with electrocautery along the transition zone showing a change in color from blue to white. The experimental lung was removed and subjected to pathologic and radiologic analysis.
After injection of indocyanine green, infrared thoracoscopy showed that the area of normal perfusion changed to blue, whereas the area at which perfusion was absent remained white. The transition zone between colors was distinct, and the blue stain remained visible during the marking procedure. Three-dimensional computed tomographic analysis indicated that the marking separated the target segmental bronchus from the adjacent one. Detailed macroscopic and microscopic study confirmed that the marking corresponded to the intersegmental line.
By using infrared thoracoscopy with indocyanine green, it is possible to detect the intersegmental line without inflating the lung.
The Journal of thoracic and cardiovascular surgery 10/2009; 138(3):613-8. · 3.41 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We evaluated the patterns of subsubsegmental pulmonary arteries of the right upper lobe (posterior segment: S2; anterior segment: S3) with multiplanar reconstruction (MPR) images by multidetector row computed tomography (MDCT).
A total of 64 patients who had undergone MDCT scans were included in the study. The subsubsegmental arteries were named by adding "i" or "ii" as the superior or the inferior branch, respectively, of the subsegmental arteries. The subsubsegmental arteries of S2 (A2ai, A2aii, A2bi, A2bii) and S3 (A3ai, A3aii, A3bi, A3bii) were evaluated as arising from either the recurrent artery (RA) or the ascending artery (AA).
A2ai originated from the RA and AA in 43 and 21 patients, respectively. The corresponding numbers were 32 each for A2aii; 28 and 36 for A2bi; 23 and 41 for A2bii; 60 and 4 for A3ai; 43 and 21 for A3aii; 59 and 5 for A3bi; and 54 and 10 for A3bii.
The branching pattern of the subsubsegmental pulmonary arteries in the right upper lobe (S2 and S3) could be visualized using MDCT with MPR images.
Japanese journal of radiology 03/2009; 27(2):86-90. · 0.65 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to investigate the accumulation of FDG in immunocompetent patients with primary central nervous system (CNS) lymphoma using qualitative and quantitative PET images and to compare baseline with follow-up PET after therapy.
Twelve immunocompetent patients with CNS lymphoma were examined. Dynamic emission data were acquired for 60 min immediately following injection of FDG. In seven patients, repeated PET studies were performed after treatment. Applying a three-compartment five-parameter model, K (1), k (2), k (3), k (4), vascular fraction (V ( B )) and cerebral metabolic rate of glucose (CMR(Glc)) were obtained. We evaluated the FDG uptake visually using qualitative and parametric images and quantitatively using parametric images.
A total of 12 lesions were identified in ten patients with newly diagnosed CNS lymphoma. On visual analysis, ten lesions showed an increase on qualitative images, eight showed an increase on K (1) images, 12 showed an increase on k (3) images and ten showed an increase on CMR(Glc) images. On quantitative analysis, k (2), k (3) and CMR(Glc) values of the lesion were significantly different from those of the normal grey matter (p<0.02-0.0005). A total of three lesions were identified in two patients with recurrent tumour. All three lesions showed an increase on qualitative, k (3) and CMR(Glc) images. The K (1), k (2), k (3) and CMR(Glc) values after treatment were significantly different from those obtained before treatment (p<0.04-0.008).
Kinetic analysis, especially with respect to k (3), using dynamic FDG PET might be helpful for diagnosis of CNS lymphoma and for monitoring therapeutic assessment.
European journal of nuclear medicine and molecular imaging 01/2007; 34(1):78-86. · 4.99 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the usefulness of SPECT images using (99m)Tc-Technegas (Technegas) and (133)Xe dynamic single photon emission computed tomography (SPECT) (Xe gas) and high-resolution computed tomography (HRCT), as compared with pathological assessment in the detection of small-airway disease including pulmonary emphysema.
Seventeen patients with lung cancer were studied. All patients who had undergone both Technegas and Xe gas and CT prior to surgery were examined. SPECT and HRCT results were compared with the results of pathological findings. Histopathological analysis was performed in an area distant from cancer in lobectomy specimens obtained at surgery. Pathological analysis was performed in relation to bronchitis, bronchiolitis, fibrosis of the alveoli and disruption in walls of the alveoli.
Pathological abnormality (mild-to-moderate abnormal change) was seen in all 17 cases. Three patients showed low attenuation areas on CT, and abnormal patterns in SPECT images. In 11 of 14 patients who showed normal findings on CT, SPECT imaging depicted abnormal findings. The remaining three patients had no abnormal findings on CT and both SPECT imaging.
Technegas and (133)Xe SPECT imaging is useful for evaluating small-airway disease including pulmonary emphysema. Furthermore, SPECT imaging is more useful than morphological HRCT imaging in the evaluation of small-airway disease including pulmonary emphysema.
Nuclear Medicine Communications 12/2006; 27(11):887-92. · 1.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: 67Ga scintigraphy has been used for years in sarcoidosis for diagnosis and the extent of the disease. However, little information is available on the comparison of 18F-FDG PET and 67Ga scintigraphy in the assessment of sarcoidosis. The purpose of this study was to compare the uptake of 18F-FDG and 67Ga in the evaluation of pulmonary and extrapulmonary involvement in patients with sarcoidosis.
Eighteen patients with sarcoidosis were examined. 18F-FDG PET was performed at 1 h after injection of 185-200 MBq 18F-FDG. 67Ga whole-body planar and thoracic SPECT images were acquired 72 h after injection of 111 MBq 67Ga. We evaluated 18F-FDG and 67Ga uptake visually and semiquantitatively using standardized uptake values (SUVs) and the ratio of lesion to normal lumbar spine (L/N ratio), respectively. The presence of pulmonary and extrapulmonary lesions was evaluated histopathologically or by the radiologic findings.
Five patients had only pulmonary lesions, 12 patients had both pulmonary and extrapulmonary lesions, and 1 patient had only an extrapulmonary lesion. Both 67Ga planar and SPECT images detected 17 of 21 (81%) clinically observed pulmonary sites. The mean +/- SD of the L/N ratio was 1.97 +/- 1.09. 67Ga planar images detected 15 of 31 (48%) clinically observed extrapulmonary sites. The mean +/- SD of the L/N ratio was 1.17 +/- 0.33. 18F-FDG PET detected all 21 (100%) clinically observed pulmonary sites. The mean +/- SD of the SUV was 7.40 +/- 2.48. 18F-FDG PET detected 28 of 31 (90%) clinically observed extrapulmonary sites. The mean +/- SD of the SUV was 5.90 +/- 2.75.
The results of this clinical study suggest that 18F-FDG PET can detect pulmonary lesions to a similar degree as 67Ga scintigraphy. However, 18F-FDG PET appears to be more accurate and contributes to a better evaluation of extrapulmonary involvement in sarcoidosis patients.
Journal of Nuclear Medicine 11/2006; 47(10):1571-6. · 6.38 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Conventional imaging techniques such as ultrasonography, CT, and MRI are able to detect gallbladder abnormalities but are not always able to differentiate a malignancy from other disease processes such as cholecystitis. The purpose of the present study was to evaluate the efficacy of dual-time-point (18)F-FDG PET for differentiating malignant from benign gallbladder disease. METHODS: The study evaluated 32 patients who were suspected of having gallbladder tumors. (18)F-FDG PET (whole body) was performed at 62 +/- 8 min (early) after (18)F-FDG injection and was repeated 146 +/- 14 min (delayed) after injection only in the abdominal region. We evaluated the (18)F-FDG uptake both visually and semiquantitatively. Semiquantitative analysis using the standardized uptake value (SUV) was performed for both early and delayed images (SUV(early) and SUV(delayed), respectively). The retention index (RI) was calculated according to the equation (SUV(delayed) - SUV(early)) x 100/SUV(early). The tumor-to-liver ratio was also calculated. Results: The final diagnosis was gallbladder carcinoma in 23 patients and benign disease in 9 patients. For visual analysis of gallbladder carcinoma, delayed (18)F-FDG PET images improved the specificity of diagnosis in 2 patients. When an SUV(early) of 4.5, SUV(delayed) of 2.9, and RI of -8 were chosen as arbitrary cutoffs for differentiating between malignant and benign conditions, sensitivity increased from 82.6% to 95.7% and 100% for delayed imaging and combined early and delayed imaging (i.e., RI), respectively. With the same criteria, specificity decreased from 55.6% to 44.4% for delayed imaging and combined early and delayed imaging, respectively. The specificity of (18)F-FDG PET improved to 80% in the group with a normal level of C-reactive protein (CRP) and decreased to 0% in the group with an elevated CRP level. For gallbladder carcinoma, both SUV and tumor-to-liver ratios derived from delayed images were significantly higher than the ratios derived from early images (P < 0.0001). CONCLUSION: Delayed (18)F-FDG PET is more helpful than early (18)F-FDG PET for evaluating malignant lesions because of increased lesion uptake and increased lesion-to-background contrast. However, the diagnostic performance of (18)F-FDG PET depends on CRP levels.
Journal of Nuclear Medicine 04/2006; 47(4):633-8. · 6.38 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Primary ovarian lymphoma as the initial manifestation is rare. A 27-year-old woman presented to our hospital with the symptoms of lower abdominal fullness and pollakisuria. CT scan and MRI revealed bilateral ovarian tumors, which showed heterogeneous masses. 18F-FDG PET revealed strong uptake by the abdominal masses, and the maximum standardized uptake value (SUVmax) was 12.5. Abnormal uptake was not shown by other regions. An exploratory laparotomy was performed. Histological findings revealed diffuse large B-cell lymphoma. The clinical stage was IV according to the Ann Arbor system. International prognostic index (IPI) was 3 (high-intermediate risk). Chemotherapy was administered consisting of three courses of an R-CHOP regimen, and 18F-FDG PET and CT scan revealed no signs of involvement 3 months after initiation of the chemotherapy. 18F-FDG PET was a useful method for staging and assessment of the therapeutic response in primary ovarian lymphoma.
Annals of Nuclear Medicine 03/2006; 20(2):157-60. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Bifid intrathoracic rib is a very rare anomaly of the ribs that is characterized by an osseous prominence of a rib into the thoracic cavity. We report a 21-year-old woman with bifid intrathoracic rib arising from the anterior-lateral portion of a depressed 4th rib, based on findings from chest radiography and computed tomography (CT). This is only the second reported case of this type of intrathoracic rib worldwide. We discuss differential diagnoses for this case and suggest a classification of intrathoracic rib from the perspective of morphology and developmental biology.
Internal Medicine 02/2006; 45(9):627-30. · 0.94 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We report a case of metastatic pulmonary calcification that appeared on high-resolution CT (HRCT) as multiple, lobular, ground-glass opacities sparing the perilobular area. Diffuse metastatic calcification such as that in our case was considered to be a result of postoperative transient acute renal failure. Decreasing alveolar air spaces due to both alveolar septal fibrosis and calcification caused the diffuse ground-glass opacities in the present case.
Radiation Medicine 10/2005; 23(6):435-8.
-
[show abstract]
[hide abstract]
ABSTRACT: Accurate baseline staging is necessary to appropriately treat pancreatic cancer. The present study was undertaken to evaluate the clinical contribution of whole body FDG-PET to the detection of distant metastasis in pancreatic cancer.
A total of consecutive 42 patients with previously untreated pancreatic cancer were examined. Whole body FDG-PET imaging for initial staging was performed with a 3D acquisition and iterative reconstruction on Siemens ECAT HR+ scanner at 1 hour post 185-200 MBq 18F-FDG injection. PET findings were correlated with clinical and radiological data to determine the impact of PET on staging.
In 16 patients, there were one or more sites of metastasis based on clinical data. FDG-PET correctly identified the presence of metastasis in 13 of 16 patients and its absence in 23 of the remaining 26 patients. Thus, FDG-PET missed 4 metastatic sites in 4 patients (liver and lung metastasis). FDG-PET correctly identified 8 metastatic sites in 7 patients (peritoneal dissemination and liver, bone and supraclavicular lymph node metastasis), which were missed on CT imaging. Based on whole body FDG-PET, the clinical stage was changed in 5 of 42 patients (11.9%).
These results suggest that FDG-PET and CT appear to have a complementary role in the detection of distant metastasis in patients with pancreatic cancer.
Annals of Nuclear Medicine 10/2005; 19(6):491-7. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Brain damage after head injury can be classified by its time course. Primary damage that includes acute subdural hematoma (SDH), acute epidural hematoma (EDH), and intraaxial lesions that include contusions, diffuse axonal injury (DAI), and intracranial hemorrhage (ICH), occurs at the moment of impact and is thought to be irreversible. Secondary damage that includes herniations, diffuse cerebral swelling, and secondary infarction and hemorrhage, evolves hours or days after injury as a consequence of systemic or intracranial complications. The duration and severity of secondary damage influence outcome. Head injury management is focused on preventing, detecting, and correcting such secondary damage. CT has been widely used for the neuromonitoring of head trauma. CT is the gold standard for the detection of intracranial abnormalities and is a safe method for survey. While MRI is more sensitive and accurate in diagnosing cerebral pathology, CT is considered the most critical imaging technique for the management of closed head-injured patients in the acute stage. In this article, we review the imaging findings and literature of various lesions of closed head injury in the acute stage.
Radiation Medicine 09/2005; 23(5):309-16.
-
[show abstract]
[hide abstract]
ABSTRACT: A 64-year-old female was found to have localized ground-glass opacity (GGO) in the middle lobe on a chest computed tomography (CT) for screening. Middle lobectomy with video-assisted thoracoscopic surgery (VATS) was undertaken, and pathological diagnosis was a bronchioloalveolar carcinoma (BAC) in stage IA. A follow-up CT a year following the surgery revealed localized GGO in area S6 of the left lung. However, it disappeared during the gravitation-dependent gradient in the observation period. The patient was scanned again under prone position to exclude the gravitational effect, resulting in definite detection of the GGO. Left extended S6 segmentectomy with VATS was performed, and pathological diagnosis was a BAC in stage IA. As GGO existing in a gravitation-dependent area may be masked by the gravitation-dependent density, a change of the scanning position may lead to a proper detection of the tumor for the diagnosis of BAC.
The Japanese Journal of Thoracic and Cardiovascular Surgery 07/2005; 53(6):309-12.
-
[show abstract]
[hide abstract]
ABSTRACT: The presence of simultaneous primary tumours in other regions affects the prognosis and management decisions of head and neck cancer patients. Therefore, early detection of these tumours is necessary. Recent improvements in positron emission tomography (PET) have made it possible to examine the patient's whole body. The present study was undertaken to evaluate the clinical contribution of whole-body PET using fluorodeoxyglucose (FDG) for head and neck cancer patients.
Fifty-three consecutive patients with previously untreated head and neck cancer were examined. Whole-body FDG PET imaging was performed at 1 h after injection of (18)F-FDG. A 3-D acquisition was undertaken and iterative reconstruction was performed. The final diagnosis of simultaneous primary tumour was established by histological findings or clinical follow-up.
Of 53 patients, six (11%) had evidence of simultaneous primary tumour. In five of these six patients, simultaneous primary tumours (two gastric cancer; one colon cancer; one pancreatic cancer; one thyroid cancer) were found by FDG PET. One more patient was found to have prostate cancer on the basis of blood test but this was not detected by FDG PET. In none of the remaining 47 patients, were additional simultaneous primary tumours found by FDG PET or any of the other routine examinations or during follow-up.
The results of this study show a high rate of simultaneous primary tumour in patients with primary head and neck cancer. FDG PET appears to be a promising imaging modality for the detection of simultaneous tumours in head and neck cancer patients.
Nuclear Medicine Communications 04/2005; 26(3):239-44. · 1.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We report a rare case of multiple rheumatoid nodules that on chest CT demonstrated peripheral location with thin-walled cavity formation, rapid increase in size within several months, and complicating pneumothorax, pneumomediastinum, and subcutaneous emphysema due to bronchopleural fistula formation.
Journal of Thoracic Imaging 03/2005; 20(1):47-9. · 0.98 Impact Factor
-
Katashi Satoh
[show abstract]
[hide abstract]
ABSTRACT: Recognition of which interlobar fissure in the right lung is major or minor is important in chest radiography. Based on assessment of the interlobar fissure, the location of diseases or the degree of expansion of the lobes is comprehensible. As a general rule, the major fissure is not seen in normal cases. However, the major fissure is visualized in the presence of volume loss of the lower lobe. Although the medial end of the minor fissure is at the intermediate artery between the upper and lower lobe bronchi, that of the major fissure is continuous to the central portion of the mediastinum. The following cases will be presented: post-pleuritis, atelectasis of the superior segment of the lower lobe (S6), obstructive pneumonia in the middle and lower lobes due to stenosis of the intermediate bronchus, pneumonia of the upper lobe, and superior accessory fissure with atelectasis of the upper lobe.
Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica 02/2005; 65(1):10-5.
-
[show abstract]
[hide abstract]
ABSTRACT: Cartilage invasion in laryngohypopharyngeal cancer has a significant impact on the choice of treatment modality and outcome of the disease. We examined invasion of cartilage in laryngohypopharyngeal cancer by simultaneous bone and tumor dual-isotope SPECT using 99mTc-hydroxymethylene diphosphonate and 201Tl-chloride.
Early and delayed simultaneous bone and tumor dual-isotope SPECT were performed on 19 patients with laryngohypopharyngeal cancer. Dual-isotope SPECT images were superimposed to project tumor location from tumor SPECT onto the osseous structures shown by bone SPECT. The presence or absence of cartilage invasion was evaluated histopathologically or by radiological studies such as CT and/or MRI.
Histopathological or radiological examination of the cartilage revealed invasion in 5 patients and no invasion in 14 patients. The results of both early and delayed dual-isotope SPECT were exactly the same. Using dual-isotope SPECT, the sensitivity, specificity, and accuracy in detecting cartilage invasion by laryngohypopharyngeal cancer were: 80% (4/5), 92.9% (13/14), and 89.5% (17/19), respectively.
Results of the present study suggest that superimposed early bone and tumor dual-isotope SPECT images may be sufficient for the diagnostic evaluation of cartilage invasion by laryngohypopharyngeal cancer. Superimposed dual-isotope SPECT imaging is a useful technique in the evaluation of cartilage invasion in laryngohypopharyngeal cancer.
Annals of Nuclear Medicine 10/2004; 18(6):527-32. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to evaluate the usefulness of 201Tl scintigraphy in comparison with three-phase bone scintigraphy in the differentiation of residual/recurrent tumors from post-therapeutic changes, in patients previously treated for bone and soft-tissue tumors.
Thirty-five 201Tl and three-phase bone scintigraphy scans were obtained for 30 patients with a history of bone or soft-tissue tumor who had undergone chemotherapy, radiation therapy, tumor resection, or a combination of these treatments. The planar 201Tl images were acquired 10 mins (early) and 2 hrs (delayed) after the intravenous injection of 111 MBq 201Tl-chloride. Three-phase bone scintigraphy was performed using 740 MBq 99mTc-HMDP at the same lesion site as for 201Tl imaging. The blood flow images were obtained every 10 sec for 2 mins and were immediately followed by the blood pool image after 5 mins. Three to 4 hrs later, bone images were obtained. 201Tl and three-phase bone scintigraphies were correlated with the histopathologic findings and/or clinical follow-up of more than 3 months.
Of the 35 cases, 15 were free of disease and 20 had residual or recurrent tumors. Of the 20 residual or recurrent cases, all had true-positive 201Tl early and delayed scans, while bone scintigraphy was true-positive on the blood flow, blood pool and bone images in 16, 18 and 12 cases, respectively. 201Tl early and delayed images and 99mTc-HMDP blood flow and blood pool images were false-positive in one patient. The histology of this false-positive case showed the presence of lymph proliferative tissue.
Although 201Tl uptake after treatment does not always indicate recurrence, 201Tl scintigraphy may still be more useful than three-phase bone scintigraphy in the follow-up of patients with bone and soft-tissue tumors following therapy.
Annals of Nuclear Medicine 06/2004; 18(3):235-41. · 1.50 Impact Factor