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Title: Scintigraphic differentiation of intrahepatic tumors

Abstract

Intrahepatic tumors in asymptomatic patients are seen with increasing frequency. Treatment is dependent of the histology; while follicular nodular hyperplasia (FNH) and hemangiomas need no further treatment, all other tumors should be resected. In a prospective study we investigated the usefulness of two-stage scintigraphy (TSS) for the differentiation. The cholescintigraphy was started with a perfusion study, followed by a scan in the parenchymal phase and in the excretion phase. There is a typical scintigraphic pattern for FNH (hyperperfusion, normal parenchymal uptake delayed excretion) and hemangioma (hypoperfusion, no uptake), while all other tumors may have a mixed pattern. Therefore a blood pool is added to look for a hemangioma, if there is no typical pattern for FNH in the cholescintigraphy. The TSS classified correct 21 of 23 patients with FNH, 17 of 18 with hemangiomas, all 3 with adenoma and 36 of 37 with primary malignant intrahepatic tumors. The TSS is more accurate than CT or sonography, safe and inexpensive and therefore the method of first choice in the differentiation of intrahepatic tumors.

Authors:
; ; ; ; ; ; ; ;
Publication Date:
Research Org.:
Medizinische Hochschule, Hannover
OSTI Identifier:
6594082
Report Number(s):
CONF-840619-
Journal ID: CODEN: JNMEA; TRN: 87-018895
Resource Type:
Conference
Resource Relation:
Journal Name: J. Nucl. Med.; (United States); Journal Volume: 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADENOMAS; SCINTISCANNING; LIVER; NEOPLASMS; ACCURACY; EVALUATION; DIAGNOSIS; EXCRETION; LABELLED POOL TECHNIQUES; PERFORMANCE; RADIOPHARMACEUTICALS; UPTAKE; BODY; CLEARANCE; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; DRUGS; GLANDS; ISOTOPE APPLICATIONS; LABELLED COMPOUNDS; ORGANS; RADIOISOTOPE SCANNING; TRACER TECHNIQUES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics

Citation Formats

Creutzig, H., Brolsch, C., Gratz, K., Neuhaus, P., Muller, St., Schober, O., Lang, W., Hundeshagen, H., and Pichlmayr, R. Scintigraphic differentiation of intrahepatic tumors. United States: N. p., 1984. Web.
Creutzig, H., Brolsch, C., Gratz, K., Neuhaus, P., Muller, St., Schober, O., Lang, W., Hundeshagen, H., & Pichlmayr, R. Scintigraphic differentiation of intrahepatic tumors. United States.
Creutzig, H., Brolsch, C., Gratz, K., Neuhaus, P., Muller, St., Schober, O., Lang, W., Hundeshagen, H., and Pichlmayr, R. 1984. "Scintigraphic differentiation of intrahepatic tumors". United States. doi:.
@article{osti_6594082,
title = {Scintigraphic differentiation of intrahepatic tumors},
author = {Creutzig, H. and Brolsch, C. and Gratz, K. and Neuhaus, P. and Muller, St. and Schober, O. and Lang, W. and Hundeshagen, H. and Pichlmayr, R.},
abstractNote = {Intrahepatic tumors in asymptomatic patients are seen with increasing frequency. Treatment is dependent of the histology; while follicular nodular hyperplasia (FNH) and hemangiomas need no further treatment, all other tumors should be resected. In a prospective study we investigated the usefulness of two-stage scintigraphy (TSS) for the differentiation. The cholescintigraphy was started with a perfusion study, followed by a scan in the parenchymal phase and in the excretion phase. There is a typical scintigraphic pattern for FNH (hyperperfusion, normal parenchymal uptake delayed excretion) and hemangioma (hypoperfusion, no uptake), while all other tumors may have a mixed pattern. Therefore a blood pool is added to look for a hemangioma, if there is no typical pattern for FNH in the cholescintigraphy. The TSS classified correct 21 of 23 patients with FNH, 17 of 18 with hemangiomas, all 3 with adenoma and 36 of 37 with primary malignant intrahepatic tumors. The TSS is more accurate than CT or sonography, safe and inexpensive and therefore the method of first choice in the differentiation of intrahepatic tumors.},
doi = {},
journal = {J. Nucl. Med.; (United States)},
number = ,
volume = 25:5,
place = {United States},
year = 1984,
month = 1
}

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  • Recently, a very promising tumor seeking agent, a Tc(V)-99m dimercaptosuccinic acid (Tc(V)-DMS), which was labelled under optimal pH 8 and very low SnCl/sub 2/ concentrations, has been developed. An equilibrium between a stable form and a dissociated form of anion TcO/sub 4//sup 3-/, structural similarity to PO/sub 4//sup 3-/, postulated for tumor uptake. And the authors have previously reported that Tc(V)-DMS scintigram would be useful in the diagnosis of medullary thyroid carcinoma. In an attempt to widen its applicability, the scintigraphic examinations of soft tissue tumors with Tc(V)-DMS and comparative study with Ga-67 citrate were performed in 58 patients. Scintigramsmore » were made 60-120 min after i.v. administration of 10 mCi Tc(V)-DMS using a conventional gamma camera. Tc(V)-DMS was found to have superior sensitivity of 90% for malignant tumors (including aggressive fibromatosis) to that with Ga-67 citrate of 56%, but inferior specificity of 71% to that with Ga-67 citrate of 80%. And the accuracy of the scan in soft tissue tumors with Tc(V)-DMS and Ga-67 citrate was 78% and 71%, respectively. Although the accumulation of Tc(V)-DMS has been detected in some benign soft tissue tumors and the exact mechanism of Tc(V)-DMS accumulation remains to be elucidated, these data indicated that Tc(V)-DMS scintigraphy would be of great use in the detection of extension or location of malignant soft tissue tumors.« less
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