[Diagnostic value of pentavalent 99mTc-dimercaptosuccinicacid ([V]-DMSA) in head and neck tumors].

The purpose of this investigation was to assess the biodistribution of 99mTc-[V]-DMSA in human being, and its diagnostic value in patients with head and neck tumours. 20 patients with histologically confirmed head and neck tumours were examined with planar as well as SPECT scintigraphy. Whole body scintigraphy in different time after injection of 99mTc-[V]-DMSA 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 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 sensitivity and specificity for the exploration of lymphadenmetastases were 75% and 100%. In conclusion, this study show 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.