Diagnostische Bedeutung von pentavalenter ~(99m)Tc-Dimercaptobern-steinsure ([V]-DMSA) bei Kopf-Hal

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The purpose of this investigation was to assess the biodistribution of 99mTc-[V]-DMSA in human being, and its di- agnostic value in patients with head and neck tumours. 20 patients with histologically confirmed head and neck tumours were ex- amined with planar as well as SPECT scintigraphy. Whole body scintigraphy in different time after injection of 99mTc-[V]-DM- SA was performed to assess the major sequential organ biodistribution. Our results showed that the blood clearance of 99mTc- [V]-DMSA was bi-exponential. All organs except kidneys showed a relatively rapid elimination of 99mTc-[V]-DMSA. The kid- neys showed a increasing accumulation in the first 2 h, which is probably due to the tubular reabsorption of 99mTc-[V]-DMSA. In 15 of 20 patients, 19 lesions could be proven by means of planar scintigraphy (corresponding sensitivity of 75%). 29 lesions in 18 patients could however be detected by the application of SPECT (corresponding sensitivity of 90%). Except primary tumours and local lymphadenmetastases in 5 patients distant metastases (3 thorax wall, 1 liver and 1 inguinal/paravesicle) were found. Altogether a sensitivity of 76. 9% and a specificity of 71. 4% were calculated for the detection of primary tumour. The sensitivi- ty and specificity for the exploration of lymphadenmetastases were 75% and 100%. In conclusion, this study shows that 99m Tc-[V]-DMSA, particularly with SPECT imaging, is useful in localising the primary tumours and lymphadenmetastases as well as distant metastases of head and neck tumours. The possible therapeutic application of 188/186Re-[V]-DMSA is also evaluated. The purpose of this investigation was to assess the biodistribution of 99mTc- [V] -DMSA in human being, and its di- agnostic value in patients with head and neck tumours. 20 patients with histologically confirmed head and neck tumors were ex- amined with Planted as well as SPECT scintigraphy. Whole body scintigraphy in different time after injection of 99mTc- [V] -DM-SA was performed to assess the major sequential organ biodistribution. Our results showed that the blood clearance of 99mTc- [V] -DMSA was bi-exponential. All organs except kidneys showed a relatively rapid elimination of 99mTc- [V] -DMSA. The kidneys showed a increasing accumulation in the first 2 h, which is probably due to the tubular reabsorption of 99mTc- [V ] -DMSA. In 15 of 20 patients, 19 lesions could be proven by means of planar scintigraphy (corresponding sensitivity of 75%). 29 lesions in 18 patients could be detected by the application of SPECT (corresponding sensitivity of 90%). Except primary tumours and Local lymphadenmetastases in 5 patients distant metastases (3 thorax wall, 1 liver and 1 inguinal / paravesicle) were found. Altogether a sensitivity of 76. 9% and a specificity of 71. 4% were calculated for the detection of primary tumor. The sensitivi - ty and specificity for the exploration of lymphadenmetastases were 75% and 100%. In conclusion, this study shows that 99m Tc- [V] -DMSA, particularly with SPECT imaging, is useful in localising the primary tumors and lymphadenmetastases as well as distant metastases of head and neck tumors. The possible therapeutic application of 188 / 186Re- [V] -DMSA is also evaluated.
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