Kashyap R, Babbar A, Sahai I, Prakash R, Soni N L, Chauhan U P
Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.
Clin Nucl Med. 1992 Feb;17(2):119-22.
Combined Tc-99m MDP skeletal imaging and Tc-99m(V) DMSA whole body scans to detect metastases were performed during the follow-up of 30 patients who underwent surgery for breast carcinoma. Eight patients had normal Tc-99m MDP and Tc-99m(V) DMSA scans and were declared free of metastatic disease, further confirmed by no change in symptomatology over a 1-year follow-up period. Twenty-two patients had positive Tc-99m MDP scans with varied skeletal involvement. Tc-99m(V) DMSA scans showed matched areas of increased radiotracer concentration in bony metastases in 20 of these patients. Tc-99m(V) DMSA concentration was not seen in traumatic vertebral collapse or in coexistent osteoarthritic disease in vertebral metastatic involvement. Interestingly, Tc-99m(V) DMSA showed increased concentration in brain and liver metastases. Pentavalent Tc-99m(V) DMSA appears useful for detecting skeletal and soft-tissue metastases in breast carcinoma, and can improve the specificity of Tc-99m MDP bone scans in screening for bone metastases.
对30例接受乳腺癌手术的患者进行随访，期间进行了联合锝-99m亚甲基二膦酸盐（Tc-99m MDP）骨显像和锝-99m（V）二巯基丁二酸（DMSA）全身扫描以检测转移灶。8例患者的Tc-99m MDP和Tc-99m（V）DMSA扫描结果正常，被判定无转移性疾病，在1年的随访期内症状无变化进一步证实了这一点。22例患者的Tc-99m MDP扫描呈阳性，骨骼受累情况各异。其中20例患者的Tc-99m（V）DMSA扫描显示骨转移灶处放射性示踪剂浓度增加区域相匹配。在创伤性椎体塌陷或椎体转移受累合并的骨关节炎疾病中未见到Tc-99m（V）DMSA浓度升高。有趣的是，Tc-99m（V）DMSA在脑转移和肝转移中显示浓度增加。五价锝-99m（V）DMSA似乎有助于检测乳腺癌的骨转移和软组织转移，并且可以提高Tc-99m MDP骨扫描筛查骨转移的特异性。
