Left ovarian vein. Unexpected renal scan finding.
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Adult↗
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Results for “Succimer”
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Imaging of soft tissue tumors with Tc(V)-99m dimercaptosuccinic acid. A new tumor-seeking agent.
Tumor scintigraphy, using Tc(V)-99m dimercaptosuccinic acid (Tc(V)-DMS) was performed in 58 patients with soft tissue tumors, and the results were compared with that of Ga-67 citrate. Tc(V)-DMS was found to have a sensitivity of 90% for malignant tumors including aggressive fibromatosis compared to that of Ga-67 citrate, which was 56%. However, the specificity of Tc(V)-DMS for these tumors was 71% but with Ga-67 citrate the specificity was 80%. The imaging accuracy 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, the reduced accumulation in inflammatory lesions compared to Ga-67 citrate was recognized, and Tc(V)-DMS could be of great use in the detection of extension or location of malignant soft tissue tumors.
Abscess↗
Is ECT imaging with Tc(V)-99m dimercaptosuccinic acid useful to detect lung metastases of osteosarcoma?
ECT imaging, using Tc(V)-99m dimercaptosuccinic acid [Tc(V)-DMS] was performed in two patients with lung metastasis of osteosarcoma, and the results were compared with those of CT scan. Clear accumulation of Tc(V)-DMS was recognized in all cases in the same area that CT scans demonstrated. Tc(V)-DMS was labeled under optimal pH 8, had very low SnCl2 concentrations, an equilibrium between a stable form and a dissociated form of anion TcO4(3-) structurally similar to PO4(3-), and was postulated for tumor uptake. Considering this proposed mechanism for Tc(V)-DMS uptake by tumor cells, ECT imaging using this tracer could be of use in the early detection of lung metastasis of osteosarcoma.
Adolescent↗
A comparison of the tumor-seeking agent Tc-99m(V) dimercaptosuccinic acid and the renal imaging agent Tc-99m dimercaptosuccinic acid in humans.
Being aware of the ideal nuclear properties of Tc-99m, our interest has been focused on the design of the (+5) oxidation state Tc-99m(V) dimercaptosuccinic acid (Tc(V)-DMSA) as a tumor-seeking agent. Tc-99m(V) DMSA holds a TcO4(3-) core and, like PO4(3-), has excellent characteristics for tumor uptake, but has a different distribution than the well-known renal scanning agent, Tc-99m DMSA. The differences in chemical behavior of Tc-99m(V) DMSA and Tc-99m DMSA are discussed. Three cases in which neoplasms were studies with Tc-99m(V) DMSA and Tc-99m DMSA are presented. Tc-99m DMSA and Tc-99m(V) DMSA, having a common ligand and tracer but, with the metal ion core in a different oxidation state, the uptake characteristics are altered markedly.
Adrenal Gland Neoplasms↗
Single photon emission computed tomography and renal pseudotumor.
Single photon emission computed tomography (SPECT), recently introduced into clinical nuclear medicine, potentially offers improved spatial resolution compared to planar imaging by eliminating activity from surrounding structures, and permitting three-dimensional reconstructions. Its clinical applications to date have been limited. A case where SPECT with Tc-99m dimercaptosuccinic acid (DMSA) better demonstrated a renal pseudotumor (a benign column of Bertin) compared to planar imaging is reported.
Adult↗
False-positive technetium-99m DMSA renal imaging in two cases of malrotated kidney.
Technetium-99m dimercaptosuccinic acid (Tc-99m DMSA) has been used as a renal imaging agent of choice. A few false-positive cases of Tc-99m DMSA imaging have been reported. The authors have experienced false-positive Tc-99m DMSA imagings in two cases of a malrotated kidney, and this finding previously has not been reported in the literature. The possibility of its nuclear imaging diagnosis with Tc-99m DTPA is also discussed.
Adult↗
The radionuclide diagnosis of horseshoe kidney.
The authors present an interesting case of horseshoe kidney diagnosed by nuclear imaging.
Female↗
Imaging of head and neck tumors with technetium(V)-99m DMSA. A new tumor-seeking agent.
Tumor scintigraphy, using Tc(V)-99m DMSA was performed on 76 patients with head and neck tumors. In 32 cases, SPECT also was performed. Tc(V)-99m DMSA was found to have a sensitivity of 75% (56 cases), a specificity of 85% (20 cases) and an accuracy of 78% on planar imaging. ECT studies showed accumulation of Tc(V)-99m DMSA in all 25 malignant cases studied. However, in benign tumors, four of seven cases (57%) showed radionuclide uptake. Tc(V)-99m DMSA has superior physical properties to Ga-67 and could be of use in the diagnosis of head and neck tumors.
Adult↗
Calculation of relative glomerular filtration rate and correlation with delayed technetium-99m DMSA imaging.
The relative renal uptake of Tc-99m DMSA was compared with the relative glomerular filtration rate (GFR) in ten patients with serum creatinines ranging from 0.3 to 2.5 mg/dl. Relative GFR was based on the renal uptake of Tc-99m DTPA determined by two methods: 1) integrating the counts from 1 to 3 minutes postinjection and correcting for background. 2) Totalizing the individual renal counts in a single 15-second frame from 2:45 minutes to 3:00 minutes postinjection and correcting for background. The two methods of determining relative DTPA uptake showed excellent correlation, r = 0.98. Relative DMSA uptake determined at 24 hours post-injection using computer-assisted regions of interest showed excellent correlation with the relative GFR determined by either the integral or single-frame method, r = 0.98. The addition of background subtraction for the DMSA images at 24 hours did not improve the correlation.
Adolescent↗
Visual determination of differential renal function.
Forty patients (43 studies) referred for determination of differential renal function were imaged 24 hours after intravenous administration of Tc-99m-2, 3 DMSA. Visual assessment of relative renal uptake was estimated independently by three observers at three different hospitals from analog images on standard x-ray film. The results were compared with the relative DMSA uptake obtained by summing counts in computer-assisted regions of interest placed over each kidney. There was excellent correlation between the visual estimates of each observer and the computer-generated values (r = 0.98, 0.96, and 0.98, respectively). If a computer is not available, good visual estimates of differential uptake still may be obtained when static imaging agents such as DMSA are administered.
Adult↗
Technetium-99m DMSA imaging and the obstructed kidney.
Although several authors have claimed that the function of an obstructed kidney could be overestimated on Tc-99m DMSA imaging, the clinical importance of such an overestimation has not been well documented. Partial obstruction of one ureter was created in a rat, and a relative Tc-99m DMSA uptake was obtained 4 hours after intravenous injection. By puncture of the isolated obstructed kidney, it was shown that the function of that kidney was overestimated by at least 17%.
Animals↗
Technetium-99m DMSA abnormal uptake by metastatic lesion of a renal cell carcinoma.
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Bone Neoplasms↗
Images of liposarcoma using technetium-99m bleomycin and technetium (V)-99m DMSA.
The effectiveness of Tc-99m bleomycin (BLM) and Tc(V)-99m DMSA are compared with that of Ga-67 citrate, which is currently the most widely used agent. In four patients with lipomatous tumors, the clinical significance of tumor imaging with each of these three agents is discussed and compared. Results indicate that both Tc-99m BLM and Tc(V)-99m DMSA are superior in detecting the extension or localization of liposarcomas.
Adult↗
Myocardial infarct imaging in patients with technetium-99m 2,3-dimercaptosuccinic acid. Superiority of technetium-99m pyrophosphate.
Technetium-99m 2,3-dimercaptosuccinic acid (Tc-99m DMSA) has been used successfully for imaging acute myocardial infarction in a canine model. The application in humans, however, has not been previously reported. In order to determine the feasibility of using this agent in clinical studies and to compare the agent to technetium-99m pyrophosphate (Tc-99m PPi), ten patients with proven myocardial infarction were studied. While imaging of transmural infarctions in humans was achieved using Tc-99m DMSA, scores for the Tc-99m DMSA images (1.8 +/- 0.96) were not as high as for Tc-99m PPi (2.5 +/- 0.45) (P less than 0.05). Discordance among four independent interpreters was greater for images obtained with Tc-99m DMSA. The superiority of Tc-99m PPi was evident whether images were obtained early (within 24 hours) or late (within five days). Although DMSA images were not obscured by rib uptake, they were less sensitive (63%) than Tc-99m PPi (97%). A potential advantage of Tc-99m DMSA in imaging acute myocardial infarction is that radiotracer concentration in the infarct occurs primarily in the early postinfarction period. The longer postinfarction that Tc-99m DMSA imaging was attempted, the lower the concentration of radiotracer. Thus, Tc-99m DMSA would not be expected to have the same persistence pattern as Tc-99m PPi into the remote postinfarction period. The persistent positivity of Tc-99m PPi has made it difficult to diagnose reinfarction.
Aged↗
New radionuclide tracers for the diagnosis and therapy of medullary thyroid carcinoma.
Medullary thyroid carcinoma (MTC), a calcitonin-producing tumor that occurs in familial and sporadic forms, can be monitored satisfactorily with measurements of calcitonin and CEA in serum. However, locating the tumor site may be difficult. In the current review of the experience with four new radionuclide tracers for MTC, the relative value of each of these procedures is outlined. Total body imaging using TI-201 chloride and Tc-99m(V) DMSA are both sensitive techniques that can be used for the detection and follow-up of MTC. Imaging using I-131 MIBG and I-131 anti-CEA antibodies/fragments should be performed once the diagnosis and the tumor site have been established, to evaluate if patients might be amenable for therapy with one of these radiopharmaceuticals.
3-Iodobenzylguanidine↗
Scintigraphic evaluation of parenchymal malakoplakia in a transplanted kidney.
The scintigraphic evaluation of a rare case of parenchymal malakoplakia in a transplanted kidney is presented. Uptake of Tc-99m DMSA in the involved area was reduced and the Ga-67 uptake was increased.
Gallium Radioisotopes↗
Avoidance of errors related to renal depth during radionuclide evaluation of renal perfusion.
Quantitative renal imaging is subject to errors related to varying renal depth. Lateral projection images, ultrasound, and geometric mean calculations can be utilized to measure renal depth or to correct for variations in the attenuation of renal activity. However, each of these methods is time consuming and each has the potential for introducing additional errors. As an alternative, the authors propose the use of quantitative indices that are insensitive to the effects of attenuation. This report illustrates how transit-time-distribution (TTD) parameters can be used to assess renal perfusion independent of varying renal depth.
Humans↗
A false positive I-131 MIBG due to dilated renal pelvis: a case report.
A case of false positive I-131 MIBG imaging for detection of pheochromocytoma is presented. There was an area of increased tracer uptake in the left renal region that showed steadily reducing activity over a period of three days. This raised the suspicion of a dilated renal pelvis, which was later confirmed by Tc-99m DTPA imaging. It is advisable in cases of ambiguous I-131 MIBG imaging to use Tc-99m DTPA rather than Tc-99m DMSA for localizing the kidneys and renal pelvis.
3-Iodobenzylguanidine↗