Detection of congenital renal anomalies in children being investigated by Tc99m-DMSA renal scan

To describe various types of congenital renal anomalies incidentally detected during routine DMSA scan in children with urinary tract infection, and to compare the incidence of scarring in patients with and without renal anomalies. This study included 400 subjects [138 boys and 262 girls], age range [one month to 15 years / Mean= 5.6 years]. In the period between May to December 2009, children were referred to Nuclear Medicine Center for Tc 99m DMSA scan to rule out renal scarring. Congenital anomalies appearance, scarring and function of kidneys were documented. Pearson correlation was used in statistical analysis and P<0.05 was considered significant. There were 55 cases of congenital kidney anomalies in our study [13.75%], within 29 boys and 26 girls. The most common congenital anomaly was single kidney seen in 17 cases [4.25%]. Renal scarring was detected in 31.25% of total cases [125 cases out of 400 cases], 30.9% of congenital anomalous kidneys [17 out of 55 cases], and in 31.3% of non-anomalous kidneys [108 out of 345 cases]. Congenital renal anomalies are not uncommon. Tc 99m DMSA scan is an adequate imaging modality to detect these anomalies and assess renal scarring. Patients with congenital anomalies did not show an increase in renal scarring compared to non-anomalous kidneys

Diagnostic value of 99m Tc-labeled red blood cell single photon emission tomography for the diagnosis of liver hemangiomas

Technetium-99m red blood cell scintigraphy is a very specific method to differentiate a hemangioma from other hepatic masses. The purpose of this study is to evaluate the efficacy of planar scintigraphy and single photon emission computed tomography Technetium-99m-labeled red blood cell in the investigation of suspected hepatic cavernous hemangioma. The study group consisdered of one hundred and five patients, 62 females [59%] and 43 males [41%], between 23-69 years of age [mean age of 41]. These patients were evaluated for liver masses found on ultrasound. The final diagnosis was made after liver biopsy or aspiration cytology in 26 patients and after folow-up by maintaining stable clinical course ranging for one year with no changes in the size or appearance of the lesion on ultrasound in 79 patients. One hundred and thirty two lesions were found; hemangioma in 96 patients and non-hemangiomatous lesions in 36 patients. Planar[99m] Tc-red blood cell showed sensitivity and specificity of 67% and 100% respectively, while [99m] Tc-red blood cell-single photon emission computed tomography showed sensitivity and specificity of 81%, 97% respectively. The use of single photon emission computed tomography showed better sensitivity value than PS from hemangiomas < 2.5 cm [61% for single photon emission computed tomography versus 24% for planar scintigraphy]. Tc-99m RBC scintigraphy is a simple, noninvasive and accurate technique in the detection of hepatic hemangioma. It can distinguish from other hepatic lesions. Single photon emission computed tomography is superior to planar imaging in the detection of small hemangioma and should be performed whenever planar imaging fails to show the lesion by 2 hours. Lesions less than 1.1 cm cannot be detected by Tc-99m red blood single photon emission computed tomography because they are beyond the limit of spatial resolution of the gamma camera used

Double-phase technetium 99m setamibi scintigraphy for the localization of parathyroid adenoma

The purpose of the present study was to evaluate the accuracy of double phase Tc99m sestamibi scintigraphy in the assessment of parathyroid glands in patients with hyperparathyroidism and to compare this method with the high-resolution ultrasonography. From August-1998 through August-2000, we performed Tc99m -MIBI scintigraphy [MIBI] and neck ultrasonography in 35 patients who were clinically and biochemically suspected of having hyperparathyroidism. All patients underwent surgical neck exploration. Before surgery, blood intact parathyroid hormone and serum calcium level were measured peripherally. Early and delayed cervical images of MIBI scans and neck ultrasonography were interpreted by two radiologists. The findings were compared to ultrasonography and scintigraphic results. The sensitivity and positive predictive values of both modalities for localizing the diseased glands were determined by comparing scan findings with pathological findings, which were considered the gold standard. All resected glands were abnormal. They belonged to 25 patients with a single adenoma, two patients with ectopic glands, two patients with double adenomas and 6 patients with hyperplastic parathyroid glands. The sensitivity and positive predictive values for localizing the diseased glands in patients with hyperparathyroidism were 91% and 97%, respectively for Tc 99m MIBI. The values were 74% and 100%, respectively, for ultrasonography. Tc 99m MIBI sensitivity was higher in patients with parathyroid adenomas [96%] than that in patients with parathyroid hyperplasia [67%]. Our results demonstrate that Tc99m sestamibi scintigraphy is highly accurate in identifying parathyroid adenoma when performed by an experienced radiologist. It is helpful in preoperative localization of parathyroid adenoma in patients with suspected ectopic glands. Nevertheless, because of the greater accessibility, lower costs and simplicity, ultrasonography could be used as a screening modality for parathyroid adenoma localization

Scintimammography with 99M technetium - methoxyisobutylisonitrile versus X-Ray mammography in the evaluation of breast masses

To evaluate the diagnostic accuracy of scintimammography using 99m Technetium - methoxyisobutylisonitrile [99mTc-MIBI] in the detection of breast cancer in comparison with conventional mammography. A total of 113 patients with clinically suspicious breast masses and/or positive mammograms suggesting breast cancers were included in this study. After 10 minutes of 99mTc-MIBI injections, one anterior image in the prone positive and two lateral prone images were acquired for 10 minutes eash. Another set of images was taken in the same position after 60 min of injection. One-hundred and nineteen lesions [92 palpable and 27 non-palpable] were detected. There were 75 malignant and 44 benign lesions according to the histopathology findings obtained during excisional biopsies. The relation with the histopathology showed that the overall sensitivity and specificity of scintimammography were 68% and 73% respectively. However for palpable lesions, the sensitivity and specificity were 79% and 76% respectively. Sensitivity was not dependent on the density of the breast tissue. The sensitivity and specificity of mammography were 89% and 43% respectively, and did not depend on the tumor size. In 60% of false-negative mammograms, 99mTc-MIBI was able to diagnose malignancy [True-positive]. Imaging with 99mTc-MIBI showed a high diagnostic accuracy for the detection of breast cancer and could be used as a complementary imaging modality to conventional mammography in diagnosing breast cancer at an earlier stage particularly in patients with dense breasts