Biomedical subjects

E Henze

Publications and source records attributed to E Henze.

At least 37 records · Page 2Linked to original sources

PubMed1999

Limited sensitivity of iodine-123-2-hydroxy-3-iodo-6-methoxy-N-[(1-ethyl-2-pyrrolidinyl)methyl ] benzamide whole-body scintigraphy in patients with malignant melanoma: a comparison with thallium-201 imaging.

The aim of this prospective study was to assess the diagnostic value of iodine-123-2-hydroxy-3-iodo-6-methoxy-N-[(1-ethyl-2-pyrrolidinyl)methyl] benzamide (IBZM) whole-body imaging in comparison to thallium-201 scintigraphy in patients with metastatic malignant melanoma. Ten patients with suspected or proven locoregional metastases of malignant melanoma underwent whole-body scintigraphy both with 201Tl and 123I-IBZM prior to scheduled surgery. Whole-body scans and planar scintigrams were acquired at 5 min and 30 min after injection of 100 MBq 201Tl and at 10 min, 2 h, 4 h and 24 h after injection of 185 MBq 123I-IBZM. Ten out of 12 melanoma metastases, both melanotic and amelanotic as proven histologically, were detected by 201Tl with a sensitivity of 83%. 123I-IBZM showed tracer uptake only in 3 melanotic metastases (sensitivity: 25%) with a maximum tumor-to-background ratio within 4 h, while none of the amelanotic metastases was IBZM-positive. All lesions localized by 123I-IBZM showed tracer uptake of 201Tl as well, while 201Tl-negative lesions were also negative with IBZM. Because of the poor results of IBZM, the study was terminated after an interim evaluation of 10 patients. 123I-IBZM is a tracer with only moderate sensitivity in melanotic melanoma lesions, suggesting that this method has no clinical value as a routine investigation in melanoma patients. In comparison, our previous results with 201Tl whole-body scintigraphy yielded a significantly higher sensitivity of about 80% in patients with locoregional melanoma metastases and may thus offer considerable potential in non-PET melanoma imaging.

Adult↗

PubMed1999

Predictive value of serum S100B for monitoring patients with metastatic melanoma during chemotherapy and/or immunotherapy.

In the immunohistology of malignant melanoma the use of polyclonal antibodies against protein S100 is well established. Recently, it was shown that S100B, a subunit of the S100 protein family, is detectable in the serum of melanoma patients and correlates with the stage of the disease in patients with metastatic melanoma. In the present study, the first evaluation of a large number of treatment observations (n = 77) in 64 different patients during chemotherapy and/or immunotherapy for advanced metastatic melanoma (stage IV) is presented. All patients received treatment according to standardized protocols comprising 8 weeks of treatment followed by routine staging procedures to evaluate therapeutic outcome. In 13 patients with tumour enlargement after first-line therapy, a second-line treatment was subsequently given. S100B immunoradiometric assay (IRMA) tests were performed before, during and after treatment at scheduled time points. In the interim analysis at 4 weeks 29 of 37 (78%) patients with tumour progression during treatment showed a raised S100B level. In the final analysis at 8 weeks, 31 of these 37 patients (84%) demonstrated rising S100B values (P < 0.001). Patients who responded to treatment (stable or regressing metastatic disease) showed constant or declining S100B levels in 38 of 40 patients (95%) at the interim analysis, at 8 weeks this was further increased to 39 of 40 patients (98%; P < 0.001). Thus, the use of S100B for monitoring treatment is adequate in the majority of cases. Our observations are of great interest for therapeutic trials of adjuvant and palliative therapies as the rise of S100B levels might indicate that re-staging and/or changes in therapy strategies should be chosen.

Adult↗

PubMed1999

Prognostic significance of serum S100B detection compared with routine blood parameters in advanced metastatic melanoma patients.

Recent reports on the use of a quantitative measurement of S100B protein for the detection of metastatic melanoma have yielded promising results. In this study we evaluated 489 serum samples from 64 patients suffering from advanced melanoma (UICC/AJCC stage IV) to compare the sensitivity of a S100B immunoradiometric assay (IRMA) with that of conventional blood parameters as well as other known clinical prognostic factors. In a univariate statistical analysis, gender, bone metastasis, and lactate dehydrogenase and S100B levels in serum samples were found to be significant prognostic markers (P<0.05). The S100B level represented the only relevant independent prognostic marker that was sustained in a multivariate analysis (P = 0.016). Furthermore, we were able to demonstrate that S100B is of relevance irrespective of the specific sites of metastatic involvement. The other laboratory parameters could not match the sensitivity rate of S100B. Overall survival rate was strongly associated with serum S100B values. The results of our study suggest that S100B might be a useful tool as a melanoma marker and an independent prognostic factor in advanced metastatic melanoma. S100B serum detection is likely to be of great interest for the pretreatment stratification and/or monitoring of patients enrolled in clinical studies.

Blood Platelets↗

PubMed1999

S100B protein detection in serum is a significant prognostic factor in metastatic melanoma.

The serum detection of S100B, a new melanoma marker, has shown clinical significance in early studies. The aim of our study of 1, 339 serum samples from 412 different melanoma patients and 107 control patients was to prove the prognostic value of serum S100B levels in melanoma patients at different stages of disease and at follow-up (median: 30 months). Using a cutoff level of 0.2 microgram/l S100B, 5 of 286 patients (1.7%) with primary tumors (stage I/II), 14/73 (19.2%) patients with locoregional metastasis (stage III) and 57/84 (67.9%) patients with advanced disease (stage IV) were S100B positive (statistically significant differences for stage I/II vs. III, I/II vs. IV, and III vs. IV, p < 0.001). The estimated overall survival time was significantly longer (p < 0.001) for patients with S100B values below 0.2 microgram/l compared to patients with elevated S100B levels (>/=0.2 microgram/l), which was independent of the stage of disease (I-IV). Regarding prognosis, we were furthermore able to distinguish different subgroups among stage III and IV patients using S100B serum levels (p < 0.01). Patients with different cutaneous non-melanoma diseases served as S100B-negative controls. S100B serum evaluations using the Sangtec(R)100 IRMA are highly specific and sensitive for the detection of metastatic melanoma. S100B has been shown to be a relevant prognostic factor for survival in a study with a large sample size of melanoma patients including close follow-up evaluations.

Adult↗

PubMed1999

Lymphoscintigraphy in tumors of the head and neck using double tracer technique.

UNLABELLED: Knowledge of possible lymphatic drainage may facilitate planning of surgery for patients with head and neck tumors. Therefore, the aim of this study was to present a method of lymphoscintigraphy with special attention to an accurate correlation of lymphatic drainage to anatomic regions. METHODS: Lymphoscintigraphy was performed using a double tracer technique before surgery in a total of 75 patients with squamous cell carcinoma of the head and neck. All patients received 100 MBq 99mTc-colloid at three to four peritumoral sites. A perchlorate solution (2 mL) was given orally to block salivary glands and the thyroid gland. Patients received 50 MBq 99mTc-pertechnetate intravenously for body contouring 20 min postinjection. Planar images were obtained over 5 min each, at 30 min and 4 h postinjection from anterior, right lateral and left lateral views with a large-field-of-view gamma camera. Lymphatic drainage was assessed by visual inspection and assigned to six cervical compartments. RESULTS: Neither the salivary glands nor the thyroid gland were seen in any of the patients. In 22 of 75 patients (29.3%), the injection site was the only focal tracer uptake seen. In contrast, lymphatic drainage was identified in the remaining 53 patients (70.7%), and lymph nodes could be assigned easily to the six cervical compartments. Of 75 patients, 36 (48%) exhibited ipsilateral lymphatic drainage. In addition, 17 patients (22.7%) with unilateral tumor showed bilateral (n = 12), contralateral (n = 2) or retropharyngeal (n = 3) lymphatic drainage. In 3 of these 17 patients, bilateral lymph node metastases were proven. A subgroup of 12 patients (16%) exhibited N2c nodal status, despite a unilateral localized primary tumor. In 3 of these 12 patients, surgery was extended as a result of scintigraphic findings from unilateral toward bilateral neck dissection, and histology confirmed nodal involvement in these patients. CONCLUSION: Lymphoscintigraphy using the double tracer technique allows an accurate correlation of lymphatic drainage to the six cervical compartments. This may provide the basis for a re-evaluation of its impact in treatment planning of patients with head and neck tumors.

Adult↗

PubMed1999

Clinical value of 24-hour delayed imaging in somatostatin receptor scintigraphy for meningioma.

UNLABELLED: Somatostatin receptor scintigraphy (SRS) using 111In-octreotide has proven useful in patients suspected of having meningiomas. Delayed imaging is regularly performed up to 24 h postinjection. However, this procedure is time consuming and expensive. Therefore, we investigated whether 24-h imaging may be omitted in these patients. METHODS: After clinical examination and standard MRI, 71 patients were suspected of having 92 meningioma lesions. Before surgery, all patients underwent SRS after intravenous injection of 200 MBq (5.4 mCi) 111In-octreotide. Planar whole-body images were obtained at 10 min and 1, 4 and 24 h, and SPECT was performed at 4 and 24 h. Results of SRS in all lesions were evaluated with respect to histology and time of image acquisition. RESULTS: SRS yielded 58 true-positive, 20 true-negative and 14 false-negative results, with the false-negatives all less than 5 mL (2.3+/-2.1 mL) in volume. In 52 of 58 true-positive lesions (89.7%), diagnosis could be established by 4-h imaging without further information by 24-h imaging. In 10 of the 52 lesions, SPECT was necessary to confirm planar findings. Imaging at 24 h was necessary in only 6 of 58 true-positive lesions (10.3%): 3 patients who had intracranial relapse of meningioma (volume < 5 mL) and 3 who had spinal meningioma. Thus, a diagnosis of intracranial meningioma could be established in 52 of 55 lesions (95%) using a 4-h imaging protocol. CONCLUSION: With a 4-h acquisition protocol that includes SPECT imaging, SRS yields sufficient information in patients suspected of having intracranial meningiomas. Delayed imaging at 24 h is recommended only for patients who have small meningiomas (volume < 5 mL), spinal localizations or negative SRS at 4 h.

Adolescent↗

PubMed1999

Radioprotection of salivary glands by amifostine in high-dose radioiodine treatment. Results of a double-blinded, placebo-controlled study in patients with differentiated thyroid cancer.

BACKGROUND AND PURPOSE: Parenchymal impairment of salivary glands following high-dose radioiodine treatment is a well-known side effect in general caused by free radicals. Therefore, the radioprotective effect of the radical scavenger amifostine was evaluated prospectively in patients receiving high-dose radioiodine treatment. PATIENTS AND METHODS: Parenchymal function was assessed by quantitative salivary gland scintigraphy performed in 50 patients with differentiated thyroid cancer prior to and 3 months after high-dose radioiodine treatment with either 3 GBq 131I (n = 21) or 6 GBq 131I (n = 29) in a double-blinded, placebo-controlled study. Twenty-five patients treated with 500 mg/m2 amifostine intravenously prior to high-dose radioiodine treatment were compared to 25 control patients receiving physiological saline solution. Xerostomia was graded according to WHO-criteria. RESULTS: In 25 control patients high-dose radioiodine treatment significantly (p < 0.001) reduced parenchymal function of parotid and submandibular glands by 40.2 +/- 14.1% and 39.9 +/- 15.3%, respectively. Nine out of these 25 patients developed Grade I and 2 Grade II xerostomia. In contrast, in 25 amifostine-treated patients there was no significant (p = 0.691) decrease in parenchymal function following high-dose radioiodine treatment, and xerostomia did not occur in any of them. CONCLUSION: Parenchymal damage of salivary glands induced by high-dose radioiodine treatment can be significantly reduced by amifostine which may improve quality of life of patients with differentiated thyroid cancer.

Adenocarcinoma, Follicular↗

PubMed1999

[Efficacy of radiation synovectomy in degenerative inflammatory and chronic inflammatory joint diseases].

AIM: Effect of radiosynovectomy (RS) should be evaluated both by subjective and objective parameters in patients with osteoarthritis and in patients with inflammatory joint disorders not caused by rheumatoid arthritis. METHODS: A total of 98 joints in 61 patients were investigated. Patients were divided into two groups. The first group included 35 patients with therapy-resistant effusions caused by severe osteoarthritis (46 joints). The second group consisted of 26 patients (52 joints) with ankylosing spondylitis, reactive arthritis, undifferentiated spondylarthropathy, psoriatic arthritis, pigmented villo-nodular synovitis, and recurrent synovitis following surgery. Effect of RS was evaluated by a standardized questionnaire and quantified by T/B-ratios derived from blood pool images prior to and after RS. RESULTS: Within the first patient group suffering from osteoarthritis, 40% showed a good or excellent improvement of clinical symptoms, 51% were unchanged, and in 9% symptoms worsened. Similar results were found in the second patient group. The majority of unchanged results were small finger joints. In contrast, wrist and knee joints showed a better improvement. Good correlation between results of bone scan and patients subjective impression was found in 38% and 67% in the first and the second patient group, respectively. CONCLUSION: Radiosynovectomy might be an effective treatment in osteoarthritis and inflammatory joint disorders not caused by rheumatoid arthritis.

Adult↗

PubMed1999

Decisive diagnosis of infected mandibular osteoradionecrosis with a Tc-99m-labelled anti-granulocyte Fab'-fragment.

The accepted golden standard for detection of inflammatory bone disease is conventional three-phase bone scanning. Hyperperfusion, a high blood-pool activity and elevated bone metabolism are typical signs for an acute osteomyelitis. However, in case of subacute, chronic inflammation, neither elevated blood flow nor high blood-pool activity may be seen. This may cause difficulties in differentiating such cases from neoplastic or postoperative changes. This case report verifies the possible advantage of immunoscintigraphy with Tc-99m-labelled anti-granulocyte Fab'-fragments (LeukoScan) in a patient with infected mandibular osteoradionecrosis, who had equivocal clinical symptoms and questionable radiographic results. LeukoScan is shown to be more sensitive in case of subacute bone inflammation compared with three-phase bone scanning. However, acquisition of delayed images after 24 hours including SPECT is inevitable in case of negative scans during the first hours of investigation.

Aged↗

PubMed1998

Salivary gland protection by amifostine in high-dose radioiodine treatment: results of a double-blind placebo-controlled study.

PURPOSE: Salivary gland impairment is a well-recognized side effect following high-dose radioiodine treatment (HD-RIT). Since differentiated thyroid cancer has a good prognosis, reduction of long-term side effects is important. Therefore, the effect of amifostine was studied in HD-RIT. PATIENTS AND METHODS: Parenchymal function was assessed by quantitative salivary gland scintigraphy performed prospectively in 50 patients with differentiated thyroid cancer before and 3 months after HD-RIT with either 3 GBq iodine ((131)I) (n=21) or 6 GBq (131)I (n=29) in a double-blind, placebo-controlled study. Twenty-five patients were treated with 500 mg/m2 amifostine intravenously before HD-RIT and 25 patients served as controls, who received physiologic saline solution. Xerostomia was graded according to World Health Organization (WHO) criteria. RESULTS: Before HD-RIT in 25 control patients, uptake of technetium-99m (99mTc)-pertechnetate was 0.45%+/-0.16% and 0.42%+/-0.16% in parotid and submandibular glands, respectively. Three months after HD-RIT, parenchymal function was significantly (P < .001) reduced by 40.2%+/-14.1% and 39.9%+/-15.3% in parotid and submandibular glands, respectively. Nine control patients developed grade I and two grade II xerostomia. In 25 amifostine-treated patients, uptake of 99mTc-pertechnetate was 0.46%+/-0.16% and 0.43%+/-0.17% in parotid and submandibular glands, respectively. Three months after HD-RIT, parenchymal function of salivary glands was not significantly altered (P=.691) and xerostomia did not occur in any of these patients. CONCLUSION: Parenchymal damage in salivary glands caused by HD-RIT can significantly be reduced by amifostine, which may improve the quality of life of patients with differentiated thyroid cancer.

Adenocarcinoma, Follicular↗

PubMed1998

Radioprotection of salivary glands by amifostine in high-dose radioiodine therapy.

UNLABELLED: Salivary gland impairment after high-dose radioiodine treatment is well recognized. Because differentiated thyroid cancer has a good prognosis, reduction of long-term side effects is important. This study investigated the radioprotective effects of amifostine in animals and humans receiving high-dose radioiodine therapy. METHODS: Quantitative salivary gland scintigraphy was performed in five rabbits before and up to 3 mo after high-dose radioiodine therapy applying 1 GBq 131I. Three animals received 200 mg/kg amifostine before high-dose radioiodine therapy, and two served as controls. All animals were examined histopathologically. Quantitative salivary gland scintigraphy also was performed in 17 patients with differentiated thyroid cancer before and 3 mo after high-dose radioiodine therapy with 6 GBq 131I. Eight patients were treated with 500 mg/m2 amifostine before high-dose radioiodine therapy, and nine served as controls. RESULTS: In two control rabbits, high-dose radioiodine therapy significantly reduced parenchymal function by 63% and 46% in parotid and submandibular glands, respectively. In contrast, there was no significant decrease in parenchymal function in amifostine-treated animals. Histopathologically, lipomatosis was observed in control animals but was negligible in amifostine-treated animals. Similar findings were observed in differentiated thyroid cancer patients. In nine control patients, high-dose radioiodine therapy significantly (p < 0.01) reduced parenchymal function by 37% and 31% in parotid and submandibular glands, respectively. Three patients exhibited Grade I (World Health Organization) xerostomia. In contrast, there was no significant decrease in parenchymal function in amifostine-treated patients and no incidence of xerostomia. CONCLUSION: Parenchymal damage in salivary glands induced by high-dose radioiodine therapy can be reduced significantly by amifostine. This may increase the quality of life of patients with differentiated thyroid cancer.

Adenocarcinoma, Follicular↗

PubMed1998

Somatostatin receptor scintigraphy in postsurgical follow-up examinations of meningioma.

UNLABELLED: Surgery is the treatment of choice in patients with meningioma. However, the risk of postoperative, local recurrence is well-known since total resection is not always feasible. Moreover, in these patients MRI may fail to differentiate between tumor remnants, recurrent meningioma or nonspecific hyperperfusion. In this study, the value of functional imaging using somatostatin receptor scintigraphy (SRS) was evaluated in postsurgical follow-up. METHODS: Before and 2-3 mo after surgery, 27 patients with meningioma received MRI as well as SRS after intravenous injection of 200 MBq 111In-octreotide. Planar whole-body images were obtained at 10 min, 1, 4 and 24 hr postinjection, and SPECT was performed at 4 and 24 hr postinjection. The final diagnosis was proven histologically in all patients. RESULTS: Before surgery, MRI showed focal contrast enhancement in all patients, and SRS revealed focal accumulation of 111In-octreotide. Thus, MRI and SRS yielded comparable results in all 27 patients. After surgery, MRI showed diffuse contrast enhancement in the area of the primary tumor site in all patients. Thus, MRI did not allow a differentiation between tumor and nonspecific hyperperfusion. In contrast, SRS revealed focal accumulation of 111In-octreotide in 16 of 27 patients indicating remaining tumor tissue or relapse of meningioma. This resulted either in an operative revision or in more frequent postsurgical follow-up examinations. In 11 of 27 patients, SRS was negative. Thus, total resection of meningioma was assumed, and no further interventions were performed. CONCLUSION: Functional imaging using SRS is a highly specific imaging modality and has a significant impact in postsurgical follow-up in patients with meningioma.

Female↗

PubMed1997

DNA ploidy and protein synthesis in squamous cell carcinoma cell lines of the head and neck.

Aneuploidy as abnormal nuclear DNA content, is considered almost positive evidence of malignancy. In this study three diploid and three aneuploid squamous cell carcinoma (SCC) cell lines were examined for DNA content by flow cytometry. The DNA indices of the SCC cell lines were found to range from 1.0 to 2.1. The mitotic activity of the diploid cell lines was 1.6 times higher and the cells were smaller than aneuploid cells. To find a molecular basis for these differences, the pattern of the de-novo synthesized proteins was analyzed by means of [35S]methionine incorporation, electrophoresis, and autoradiography. In all aneuploid SCC cell lines tested in this experiment, the increase of nuclear DNA content is associated with the synthesis of a novel protein with a molecular mass of approximate 55 kDa as well as with altered synthesis rates of two preexisting proteins (50 kDa and 100 kDa). For determination of the amino acid uptake in diploid and aneuploid cells, the accumulation of [35S]methionine was measured as a function of time by liquid scintillation counting. No significant difference was found in the uptake rate between diploid and aneuploid cells with the same protein content. However, discrepancies were revealed when equal numbers of cells with different DNA index were used, suggesting, that protein turnover is different in diploid and aneuploid SCC cells.

Aneuploidy↗

PubMed1997

Quantification of diphosphonate uptake based on conventional bone scanning.

Up to now there has been no routinely used and easy-to-perform method for the quantification of bone uptake. Therefore, we have evaluated the clinical practicability of a new and simple method for the measurement of bone uptake based upon conventional three-phase bone scanning. In 13 patients with normal bone scans, whole-body scintigrams were obtained at 3 min and 1, 2, 3, 4, 5, 6 and 24 h after injection of 600 MBq technetium-99m hydroxymethylene diphosphonate (HMDP). Using a conventional region of interest technique, fitted time-activity curves of soft tissue and urinary excretion were established, and bone uptake was calculated from these data as the total whole-body activity minus both soft tissue activity and urinary excretion. Subsequently, the new method was tested in routine patient management: 32 healthy patients and five patients with different types of metabolic bone disease were investigated, measurements being performed only at 3 min and 3-4 h p. i. during conventional three-phase bone scanning. In the multi-imaged patient subset, soft tissue activity decreased exponentially, reaching a plateau after 6 h with a residual activity of about 14% of initial total whole-body activity. Bone uptake reached quite a stable plateau of about 27% as early as 3 h p.i., with no significant changes up to 24 h. Healthy patients of the two-scan group showed no differences in bone uptake (mean uptake values were 24.1% in women and 26.9% in men), whereas in patients with metabolic bone disease bone uptake was significantly higher, with a mean of 48% (P <0.05). Thus, the results of this method are in good agreement with the findings of standard 24-h whole-body retention measurements. The new method, however, is easy to perform, allows assessment of pure bone uptake instead of whole-body retention, and permits calculation of bone uptake by only two measurements during routine three-phase bone scanning.

Adult↗

PubMed1997

Postischemic synthesis of high energy phosphates in isolated porcine hearts during reperfusion with 11 or 25 degrees C hypothermic perfluorocarbon emulsion FC 43. A 31P magnetic resonance spectroscopy study.

OBJECTIVE: One aim of coronary reperfusion after myocardial ischemia is to restore the myocardial content of high energy phosphates. The superiority of the artificial oxygen carrier perfluorocarbon emulsion FC43 over blood solution is known, therefore, in this paper we examined the temperature-dependence of this substance. METHOD: The changes of the high energy phosphates phosphocreatine (PCr) and inorganic phosphate (Pi) were documented in 29 isolated pig hearts, employing a 4.7 Tesla magnetic-resonance-spectroscope (MRS). After 15 min warm ischemia, reperfusion with warm blood and a cardioplegic ischemia period of 45 min, these hearts were reperfused with either 11 or 25 degrees C hypothermic oxygenated perfluorocarbon emulsion FC43, both under continuous spectroscopy. MRS is able to directly measure PCr as well as Pi. Their relation expresses the state of myocardial energy stores. RESULTS: Reperfusion with 11 degrees C hypothermic FC43 (n = 14) caused an increase of the relation PCr to Pi by a factor of 9, compared to an increase by a factor of 4 with 25 degrees C emulsion (n = 15) (P < 0.05). During 80 min of reperfusion with 11 degrees C cold FC43 emulsion the average flow rate was 90 +/- 12 and 96 +/- 11 ml/min during reperfusion with 25 degrees C hypothermic FC43 emulsion. Both rates fell only slightly in the course of time. CONCLUSION: We conclude that reperfusion with 11 degrees C hypothermic oxygenated FC43 in isolated ischemic porcine hearts leads to a clear increase of the index PCr/Pi compared with reperfusion at 25 degrees C. The correlation between the synthesis of myocardial high energy phosphates with postcardioplegic ventricular function is questionable. If further studies will show an improvement of myocardial function after perfusion with hypothermic oxygenated perfluorocarbon emulsion FC43, this solution may find clinical application in the storage of explanted human hearts for transplantation, during transportation to the recipient.

Animals↗

PubMed1997

[Implementation and indications for quantitative sialoscintigraphy].

BACKGROUND: Since its introduction in 1965 salivary gland scintigraphy has been an established method to simultaneously investigate excretion function in major salivary glands. In order to elucidate parenchymal function of salivary glands, several authors described various quantitative and semiquantitative methods. However, no standardized protocol for quantitative salivary gland scintigraphy has been established so far. METHODS: Therefore, in this paper we report on a standardized and validated acquisition protocol for salivary gland scintigraphy using 99mTc-pertechnetate. RESULTS: A normal data base for both parenchymal and excretion function is given in detail. In addition, the diagnostic value of salivary gland scintigraphy is reviewed in various clinical settings, such as mild parenchymal damage in beginning Sjögren's syndrome, proof of functional obstruction in sialolithiasis with and without parenchymal damage, and parenchymal damage following radioiodine treatment. In a second part, applications of salivary gland scintigraphy in current clinical research are described, and radiation protection of salivary glands in rabbits and patients treated with high doses of I-131 are discussed. CONCLUSIONS: Salivary gland scintigraphy is a study that is easily performed and well tolerated by the patient. It yields quantitative parameters for parenchymal function and excretion fraction.

Animals↗

PubMed1997

[Lymphoscintigraphy with double tracer technique in carcinomas of the head-neck region].

BACKGROUND: Lymphoscintigraphy has been used since the early 1960s to demonstrate lymphatic drainage of head and neck tumors, but did not prove satisfactory. With the increasing importance of highly sophisticated neck dissection procedures, lymphoscintigraphy may have greater diagnostic impact. This assumes that lymphoscintigraphy will allow an accurate correlation of lymphatic drainage with anatomic structures. In this paper, we report on a method of lymphoscintigraphy with simultaneous body contouring. METHODS: Double-tracer lymphoscintigraphy was performed in 78 patients with squamous cell carcinoma. Patients received 100 MBq 99mTc-colloid in 0.1-0.2 ml in 3-4 peritumoral localizations. Ten patients were injected during surgery. Two milliliters of perchlorate solution were given orally in order to block the thyroid. Twenty minutes later patients received 50 MBq 99mTc-pertechnetate i.v. for body contouring. Planar images were obtained over 5 min each at 30 min and 4-6 h after injection from anterior, right lateral and left lateral using a LFOV-gamma camera. RESULTS: The thyroid was not visualized in any of the patients. In 28 of 78 patients (36%), the injection site was the only focal activity seen. In 50 of 78 patients (64%), lymph drainage was observed. Thirty-six of 78 patients (46%) showed unilateral lymphatic drainage, and 14 of 78 (18%) showed bilateral drainage. In all 50 patients showing lymphatic drainage, lymph nodes could be easily assigned to the six cervical lymph node compartments described. CONCLUSIONS: Double-tracer lymphoscintigraphy enables an accurate correlation of cervical lymph nodes and anatomic structures of the head and neck region. These findings suggest that the impact of these studies on the preoperative planning for neck dissection should be reevaluated.

Adult↗

PubMed1997

201Tl whole-body scintigraphy in patients with malignant melanoma.

The aim of this study was to evaluate 201Tl whole-body imaging in the detection of metastases prior to surgery in patients with malignant melanoma. Whole-body imaging was performed in 30 patients with known or suspected metastases 5 and 30 min after administration of 150 MBq 201Tl. The imaging results were compared with the histopathological findings in each patient on a lesion-by-lesion basis. Of the 39 metastases proven histopathologically, 34 were detected by 201Tl imaging (sensitivity = 87%), including 4 in-transit metastases and one inguinal lymph node metastasis which were unknown prior to investigation. Due to these additional findings on 201Tl imaging, scheduled surgical therapy was changed in three patients. 201Tl imaging was false-negative in four lymph node metastases and one skin lesion, and there were two false-positive 201Tl scans with tracer accumulation in inflammatory sites. The mean target-to-background ratio on the true-positive scans was 1.72 +/- 0.37 and 1.67 +/- 0.41 (P > 0.05) at 5 and 30 min post-injection respectively. In conclusion, 201Tl whole-body imaging appears sensitive and simple to perform in the detection of metastases prior to surgery in melanoma patients.

Adult↗