Oyamada H, Yamazaki S, Makuuchi M, Hasegawa H
Department of Nuclear Medicine, Cancer Institute Hospital, Tokyo.
Radioisotopes. 1989 May;38(5):244-51. doi: 10.3769/radioisotopes.38.5_244.
Hepatobiliary scintigraphy with 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) was carried out on 48 patients with intrahepatic masses, 44 with hepatocellular carcinoma and one each of hepatocellular adenoma, focal nodular hyperplasia, cholangiocellular carcinoma, and adenoid cystic carcinoma. Scans were performed twice, early scan (30 min post i.v.) and delayed scan (2.5 h post i.v.), and the delayed scan was used for assessing the accumulation of 99mTc-PMT in the intrahepatic masses. In the hepatocellular carcinoma group, based on individual patients, 17 out of 44 (38.6%) showed accumulation of 99mTc-PMT in various degrees; and based on individual masses, accumulation was noted in 21 out of 55 masses (38.2%). However, only the cases which had not received transarterial infusion of anti-cancer drugs (TAI) and/or blocking agents (TAE) were taken into consideration, 9 out of 18 patients (50%) and 12 out of 25 masses (48.0%) were found capable of picking up 99mTc-PMT. A case of hepatocellular adenoma showed a strong accumulation of 99mTc-PMT in the mass which was depicted as a defect on the 99mTc-colloid scan and did not show a significant accumulation of 67Ga. In a case of focal nodular hyperplasia, there were two space-occupying lesions (SOLs), one of which showed a clear-cut defect on the 99mTc-colloid scan and the other which showed only a distorted uptake pattern. However, both masses were strongly positive with 99mTc-PMT. 99mTc-PMT scintigraphy is useful in connection with 99mTc-colloid scan and sometimes with 67Ga-citrate in the diagnosis of intrahepatic masses originating from hepatocytes.
对48例肝内肿块患者进行了用99m锝-N-吡哆醛-5-甲基色氨酸（99mTc-PMT）的肝胆闪烁显像，其中44例为肝细胞癌，1例肝细胞腺瘤、1例局灶性结节性增生、1例胆管细胞癌和1例腺样囊性癌。扫描进行两次，早期扫描（静脉注射后30分钟）和延迟扫描（静脉注射后2.5小时），延迟扫描用于评估99mTc-PMT在肝内肿块中的蓄积情况。在肝细胞癌组中，基于个体患者，44例中有17例（38.6%）显示不同程度的99mTc-PMT蓄积；基于单个肿块，55个肿块中有21个（38.2%）有蓄积。然而，仅考虑未接受过动脉内抗癌药物灌注（TAI）和/或阻断剂（TAE）的病例，18例患者中有9例（50%）和25个肿块中有12个（48.0%）被发现能够摄取99mTc-PMT。1例肝细胞腺瘤病例显示肿块内99mTc-PMT强烈蓄积，该肿块在99mTc胶体扫描中表现为缺损，且未显示67Ga的明显蓄积。在1例局灶性结节性增生病例中，有两个占位性病变（SOL），其中一个在99mTc胶体扫描中显示明确的缺损，另一个仅显示摄取模式扭曲。然而，两个肿块对99mTc-PMT均呈强阳性。99mTc-PMT闪烁显像结合99mTc胶体扫描，有时结合67Ga枸橼酸盐，对诊断源于肝细胞的肝内肿块很有用。
