[Scintigraphy and fine needle biopsy in nodular goiter. Results in 548 patients]. / Szintigraphie und Feinnadel-Punktion bei der Struma nodosa. Ergebnisse bei 548 Patienten--Schluss.

The results of scintigraphic and cytological investigations in 548 patients with goiter are presented: In 402 goiters 470 nodes were detected, 385 of which were scintigraphically "cold". 276 solitary nodules were found, 109 in cases of multinodular goiter. Solitary nodules were preferentially located in the right lobe. The cytological diagnosis was confirmed histologically in 88 cases. Out of 24 malignant tumors, 21 were diagnosed correctly by means of cytology. The positive smears and the histological findings were in agreement in 14 of 15 cases. The accuracy of cytological diagnosis in the detection of thyroid malignancies was 87.5%. 12.5% of the smears were false negatives, 1.6% false positives and 10.9% false suspicious. The relative high percentage of false suspicious smears is caused by difficulties in cytologic differentiation of thyroid lesions due to microfollicular structures which are usually only classified as "follicular neoplasia". This cytologic term necessitates an obligatory histologic examination since cytology does not allow to differentiate between follicular adenomas and carcinomas. 5.5% of the histologically ascertained cold nodules were malignant, in 19% of the cases with cold nodes thyroid punction revealed cystic lesions.

[Scintigraphic and experimental studies with 67Ga in 142 patients with bronchial cancer (author's transl)]. / Szintigraphische und klinisch-experimentelle Untersuchungen mit 67Ga an 142 Bronchialkarzinomen.

In 142 patients with untreated bronchial carcinoma positive 67Ga scintigrams were obtained in 132 cases (93%). 6 of 10 scintigraphically not detected tumors had diameters less than 2 cm, 4 carcinomas presumably consisted of necrotic tumor masses. There was no dependence of 67Ga accumulation on the histomorphological type of tumor. Differentiated and undifferentiated carcinomas showed a comparably high 67Ga uptake. These scintigraphic findings were confirmed by measuring the quantitative 67Ga concentration in 132 tissue samples of various tumors. In addition these studies revealed an absent or decreased 67Ga accumulation in more or less necrotic tumor masses. The positive tumor scintigraphy with 67Ga-citrate as a non-invasive method is suitable for detecting untreated bronchial carcinomas, especially those localized in the hilar or mediastinal region, which cannot be visualized roentgenologically as well as for indicating the effectiveness of radio- or chemotherapy. 67Ga scanning is also useful in establishing the reappearance of viable tumor tissue in follow-up studies of tumor diseases. The use of 67Ga as a tumor-seeking scanning agent is limited because of its lack of tumor specifity and of its inability to detect tumors smaller than 2 cm in diameter.

[Diagnosis of skeletal metastases in prostatic cancer using gamma camera (author's transl)]. / Kameraszintigraphische Metastasendiagnostik am Skelettsystem beim Prostatakarzinom

On 170 patients with histologically proven carcinoma of the prostate scintigraphic studies of the skeleton using gamma camera and follow-up examinations were performed and compared with x-ray as well as serum alkaline and acid phosphatase. Osseous metastases in 47% had no radiological evidence and were only scintigraphically detectable. Positive scans were registered in 48% of the patients with prostatic cancer, 20% of them were positive due to metastases and 28% were false positive caused by osteoarthrotic and arthritic changes, sporadically by post-traumatic lesions and in 3 cases by Paget's disease. At the time of the initial diagnosis of prostatic cancer 21% of 159 patients studied scintigraphically had radiological or scan evidence of osseous metastases. Analyses corresponding stages of tumor revealed an unequivocal dependance of the frequency of metastases upon the extent of the primary tumor. The successful treatment is characterized by the decreased uptake of radioactivity primarily accumulated in skeletal metastases.

[Fine-needle aspiration biopsy in the diagnosis of thyroid diseases (author's transl)]. / Die Feinnadelpunktion in der Schilddrüsendiagnostik

879 fine-needle biopsies obtained from 754 patients with palpable lesions of the thyroid were evaluated. Cold nodules were identified in the scintigram of 509 patients. The cytologic findings could be checked by histology in 102 cases. 24 out of 26 malignant tumors of the thyroid were recognized cytologically. In 23 cases the tumor type was correctly identified by cytology. The cytologic report was false negative in two cases. Follicular adenoma and follicular carcinoma are not distinguishable on cytologic grounds. In 14.7% of patients the cytologic report stated cystic lesions and in 1.7% of patients inflammatory lesions.

[Measurement of renal blood flow with the Anger scintillation camera after selective intra-arterial injections of 133xenon and 99mtechnetium]. / Die Messung der Nierendurchblutung mit der Anger-Szintillationskamera nach selektiver intraarterieller Injektion von 133-Xenon und 99m-Technetium

A "region of interest" technique for measuring renal blood flow is described, using as Anger camera and selective intra-arterial injection of 133Xe and 99mTc. The sequence of measurements has the advantage of providing information on regional blood flow. The values for RBF and RBFD obtained with 133Xe agree with those in the literature. Selective determination of the RCBF with the "region of interest" technique using 133Xe was not possible. Mean transit time for 99mTc was calculated after correction of the 99mTc indicator dilution curve with respect to recirculation and background activity. All typer of pathological changes in the kidney showed a statistically significant increase in mean transit time when compared with a control group. In patients with uncomplicated essential hypertension, the mean transit time was signigicantly reduced. A comparison of the mean transit time of 99mTc with the haemodynamic parameters derived from the 133Xe studies, and experiments with pharmocologically induced vasoconstriction indicates that the mean transit time represents a measure of the RCBF.