Lymphoscintigraphy for interpretation of changes of cervical lymph node function in patients with oral malignant tumors: Comparison of Tc-99m-Re and Tc-99m-HSA-D

Objective. The purpose of this study is to compare the usefulness of technetium-99m-rhenium colloid (Tc-99m-Re) and technetium-99m-human serum albumin diethylene-triamine-pentaacetic acid (Tc-99m-HSA-D) as lymphoscintigraphic agents and to discuss the significance of lymphoscintigraphy in comparison...

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Published in:Oral surgery, oral medicine, oral pathology, oral radiology and endodontics oral medicine, oral pathology, oral radiology and endodontics, 2000-10, Vol.90 (4), p.525-537
Main Authors: Sato, Tsuyoshi, Yamaguchi, Kohjirou, Morita, Yasuhiko, Noikura, Takenori, Sugihara, Kazumasa, Matsune, Shoji
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Carcinoma, Squamous Cell - diagnosis
Carcinoma, Squamous Cell - pathology
Chi-Square Distribution
Dentistry
Ent. Stomatology
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Lymph Nodes - diagnostic imaging
Lymph Nodes - physiopathology
Lymphatic Metastasis - diagnostic imaging
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Mouth Neoplasms - diagnosis
Mouth Neoplasms - pathology
Neck
Otorhinolaryngology. Stomatology
Palpation
Radionuclide Imaging - methods
Radionuclide investigations
Radiopharmaceuticals
Reproducibility of Results
Rhenium
Sensitivity and Specificity
Technetium Compounds
Technetium Tc 99m Aggregated Albumin
Technetium Tc 99m Pentetate
Tomography, X-Ray Computed
Tumors
Ultrasonography
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:Objective. The purpose of this study is to compare the usefulness of technetium-99m-rhenium colloid (Tc-99m-Re) and technetium-99m-human serum albumin diethylene-triamine-pentaacetic acid (Tc-99m-HSA-D) as lymphoscintigraphic agents and to discuss the significance of lymphoscintigraphy in comparison with computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography (US). Study Design. Dynamic and static lymphoscintigraphies were performed with Tc-99m-Re and Tc-99m-HSA-D. The usefulness of the 2 agents was evaluated statistically in comparison with pathologic findings and palpation. The significance of lymphoscintigraphy is discussed in comparison with CT, MRI, and US (by the literature of CT, MRI, and US). Results. Lymphoscintigraphy was superior to palpation, and Tc-99m-Re was superior to Tc-99m-HSA-D in accuracy, specificity, and the incidence of true-positive and false-positive. Statistical significance was shown between the static lymphoscintigraphy with Tc-99m-Re and palpation. The reliability of lymphoscintigraphy seemed to be slightly inferior to CT and MRI in specificity and accuracy. However, lymphoscintigraphy had some advantages that CT and MRI lacked; for example, it showed very high sensitivity (100%) and no false-negative (0%). It also showed changes of lymph node function, showed all levels of neck nodes at one time, and showed a possibility of detecting small lymph node metastases. Conclusion. Lymphoscintigraphy was more useful than palpation in detecting lymph node metastases, and Tc-99m-Re was superior to Tc-99m-HSA-D as an agent. Lymphoscintigraphy is significant when it is performed as a preliminary examination before CT or MRI. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:525-37)
ISSN:1079-2104
1528-395X
DOI:10.1067/moe.2000.109190