Subject(s)
Mediastinal Cyst/diagnosis , Ultrasonography , Adult , Female , Humans , Radiography, ThoracicABSTRACT
Two hundred abnormal bone scans of patients with a malignant melanoma were reread in a blinded fashion to identify osseous metastases. These findings were compared with serum calcium and alkaline phosphatase levels, skeletal surveys and survival curves of the same patients. Thirty-four of the 38 patients classified as positive for osseous metastases by bone scans ultimately supported that diagnosis. Three patients have probable, but not proved, osseous metastases, and one patient is classified as false-positive. Identification of osseous metastases by skeletal surveys never preceded bone scan identification. Skeletal surveys were most helpful in the identification of a benign condition which caused scan positivity. Serum calcium and alkaline phosphatase levels were never as sensitive or specific as either scans or surveys. In two patients with progressive osseous disease, the levels fell. We believe that radionuclide bone scans should be the first diagnostic procedure for suspected osseous metastases in patients with a malignant melanoma. It appears to be a more sensitive and specific test than skeletal surveys or serum calcium and alkaline phosphatase levels. We believe its use as a first test would save time, money and needless surgical procedures.
Subject(s)
Bone Neoplasms/diagnostic imaging , Melanoma/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Adult , Aged , Alkaline Phosphatase/blood , Bone Neoplasms/pathology , Bone Neoplasms/secondary , Calcium/blood , Female , Humans , Lymphatic Metastasis , Male , Melanoma/pathology , Middle Aged , Neoplasm Metastasis , Radionuclide Imaging , Skin Neoplasms/pathologyABSTRACT
The records of 122 patients with non-Hodgkin's lymphoma were reviewed, and the findings of the gallium scan analyzed. The scans of 93 patients were reread without knowledge of the previous readings. Two nuclear medicine physicians agreed with the original readings in 70 per cent of the cases and with each other in 89 per cent of the cases. When the data are analyzed case by case, 52 per cent true positive, 13 per cent false positive and 34 per cent false negative scans were found with only 17 per cent of the scans locating disease not found by routine physical examination and roentgenograms. Looking at individual sites of disease, the gallium scan yields an over-all detection of diseased sites of 18.5 per cent, with 72 per cent of all sites being correctly classified as positive or negative. The diffuse histiocytic, mixed and undifferentiated histologies were detected more accurately than all others, with mediastinal and extranodal sites being identified more frequently than any nodal site. The gallium scan revealed a site of disease which advanced the clinical stage in only one of 122 patients (upstaged). Only one of 122 patients was upstaged as a result of gallium scanning. These data suggest that gallium scanning may not be cost effective in the routine staging of patients with non-Hodgkin's lymphoma.
Subject(s)
Gallium Radioisotopes , Lymphoma/pathology , Neoplasm Staging/methods , Cost-Benefit Analysis , Evaluation Studies as Topic , False Negative Reactions , False Positive Reactions , Humans , Lymphography , Lymphoma/diagnostic imaging , Radionuclide Imaging/economicsABSTRACT
The sacral tubercle, S1 posterior spinous process, can appear as intense as the sacroiliac joints on posterior bone scan in 4% of normal adult male patients. Due to sexual differences in anatomy, the scan appearance of the sacrum can cause false-positive readings. The converse, false-negative readings, can occur if the sacral intensity is taken as a constant when comparing ratios of sacroiliac joint intensities and sacral intensities on bone scans of patients with sacroiliac disease. This study demonstrates the normal anatomy of the sacrum and presents a sequence of tests to diagnose disease in the sacrum.
Subject(s)
Sacrum/diagnostic imaging , Adolescent , Adult , Age Factors , Bone Neoplasms/diagnostic imaging , Diagnostic Errors , Female , Humans , Male , Neoplasm Metastasis , Radionuclide Imaging , Sacrum/anatomy & histology , Sex FactorsABSTRACT
In a 20-year-old man, computed tomography revealed that an orbital mass in the region of the lacrimal gland fossa had low density attenuation values (below water), indicating a fat-containing tumor. At surgery, we found a dermoid cyst of the oil cyst type.
Subject(s)
Dermoid Cyst/diagnostic imaging , Orbital Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Adult , Humans , MaleABSTRACT
The brain imaging properties of 99mTc glucoheptonate, 99mTc pertechnetate, and 99mTc DPTA are compared. Results demonstrate that optimum images are obtained at 90, 180, and 180 min., for 99mTc GH, 99mTc DTPA, and 99mTc perterchnetate, respectively. The former two images are not affected by prior bone imaging with 99mTc pyrophosphate, while 99mTc pertechnetate images are adversely affected. 99mTc glucoheptonate appears to be the superior agent for brain imaging, followed by 99mTc DTPA and 99mTc pertechnetate.