The value of Tc-99m(V) DMSA scintigraphy in the diagnosis and staging of malign neoplasms

Abstract

In order to evaluate the value of Tc-99m (V) DMSA in the diagnostic evaluation of various malignancies, 15 patients were undergone scintigraphy with Tc-99m (V) DMSA. The patients were all male and the mean age was 59.3+/-7.4. 12 of the cases were primary and metastatic lung cancers, 2 were renal cell carcinomas and 1 of them was gastric cancer. Total body imaging was done in all the. patients after 2 hours of radionuclide administration and SPECT was performed in patients with lung lesions. The patients were also evaluated with bone scintigraphy, ultrasonography and computed tomography of the involved organ and the results were compared. Lung lesions were demonstrated in 14 patients with computed tomography of the chest. 6 of the 7 peripherally located lesions were detected by Tc-99m (V) DMSA. Of the 7 lesions with central location only 1 could be detected by scintigraphy. In all of the 7 patients with bone metastases lesions were also visualised by Tc-99m(V) DMSA also. No intraabdominal metastases could be visualized by Tc-99m(V) DMSA. As a result of this study, Tc-99m (V) DMSA seems to be a valuable method to detect peripheral but not central lung lesions, either metastatic or primary. This method has an ability to visualize bone metastases synchronously with the primary lesion which presents a great advantage in the staging of various tumors. Also considering the capability, to differentiate viable and non-viable tissues of this technique, Tc-99m (V) DMSA scintigraphy can be regarded as a valuable method in the staging and follow up of peripheral lung lesions either metastatic or primary. The disadvantages of this technique are insensitivity far mediastinal lesions due to blood pooling in this region and inability to show intraabdominal organ metastases.