Scintiscanning of the breast with 99Tcm-diethylene triamine penta-acetic acid--a prospective blind evaluation

Incidental DTPA and DMSA uptake during renal scanning in unknown bone metastases

We report a patient with DTPA and DMSA uptake on unsuspected bone metastases. He had severe pain due to grade 3 hydronephrosis of his left kidney. When Tc-99m DTPA and DMSA renal scanning were performed for preoperative evaluation, abnormal radiopharmaceutical uptake on the iliac area was noted. Pancreatic adenocarcinoma metastases to bone were subsequently defined. This patient is a very demonstrative case in respect of having all DTPA, DMSA and HDP uptakes in bone metastases. The type of the tumor has to be added to the list of extrarenal uptake of DTPA and DMSA as a rare cause.

Breast cancer diagnosis by scintimammography: a meta-analysis and review of the literature

Scintimammography is a relatively new, non-invasive diagnostic modality in the evaluation of breast cancer. The purpose of the current study was to review the existing literature on the accuracy of scintimammography in the diagnosis of breast cancer. A search of all articles published between 1st January 1967 and 31st December 1999 was conducted. A total of 64 unique studies were selected. Each scientific paper was reviewed for scientific merit by an epidemiologist, a surgeon and a surgical resident. Assessment of scientific merit was based on a scoring scheme developed for the study. The articles included in this review reported data on a total of 5340 patients assessed for breast cancer with scintimammography. The aggregated summary estimates on these patients were sensitivity: 85.2% and specificity: 86.6%. For patients with a palpable mass the sensitivity and specificity were 87.8 and 87.5%, respectively. For patients without a palpable mass the sensitivity was 66.8% and that for specificity was 86.9%. The results of this review have shown that scintimammography may be used effectively as an adjunct to mammography and physical examination in the diagnosis of breast cancer.

Nuclear medicine in primary breast cancer imaging

The application of nuclear medicine techniques to study patients with breast cancer has recently raised its profile, particularly in the investigation 'indeterminate mammographic lesions'. This review briefly points out some of the difficulties encountered with other more conventional imaging modalities and describes the radionuclide techniques most frequently employed in the investigation of those patients with breast cancer. Both planar and single photon emission tomography methods are discussed including the use of monoclonal antibodies, perfusion ligands, receptor binding hormones and other specific radiotracers, non-specific tumour markers, as well as deoxyglucose and other amino acids labelled with positron emitting radionuclides.

Tc-99m DTPA used as reference imaging to evaluate the distribution of other tumor-seeking tracers in tumors associated with neurofibromatosis

Two patients with multiple benign and malignant tumors associated with neurofibromatosis underwent radionuclide imaging with Tc-99m DTPA, Tl-201, and Ga-67. In these patients, Tc-99m DTPA accumulated intensively in both the benign and malignant tumors and localized and defined the extent of every tumor. In contrast, Ga-67 and Tl-201 uptake was seen only in focal areas of tumor where there was malignant transformation or at sites that showed progressive tumor growth. Tc-99m DTPA imaging accurately demonstrated areas of neoplastic involvement and identified the areas that would be seen with the other two tracers in individual tumors. Tc-99m DTPA may not always be used for the differential diagnosis of malignant and benign tumors of neurofibromatosis, but it can provide a reference pattern for imaging to evaluate accurately the distribution of Tl-201 and Ga-67 by mapping out the anatomic extent of these tumors.

Breast scintigraphy with 99mTc-diethylene triamine penta-acetic acid for the detection of malignant disease

A single-blind prospective study of 99mTc-diethylene triamine penta-acetic acid (DTPA) breast scintigraphy was performed on 160 women who presented at the outpatient clinic with suspected breast tumour. The sensitivity of scintigraphy in establishing the diagnosis of breast cancer was 75 per cent. The specificity of scintigraphy in excluding the presence of breast cancer was 91 per cent. The diagnostic value of DTPA breast scintigraphy is at present too low in comparison with mammography to be clinically useful.