Pentavalent Tc-99(m)-DMSA imaging in patients with bone metastases

TY - JOUR

T1 - Pentavalent Tc-99(m)-DMSA imaging in patients with bone metastases

AU - Lam, A. S. K.

AU - Kettle, A. G.

AU - Odoherty, M. J.

AU - Coakley, A. J.

AU - Barrington, S. F.

AU - Blower, P. J.

N1 - M1 - 10 Times Cited: 23

PY - 1997

Y1 - 1997

N2 - Pentavalent Tc-99(m)-dimercaptosuccinic acid (Tc-99(m)-(V)DMSA) has an established role in imaging medullary thyroid carcinoma. There have been case reports of uptake in bone metastases. Our aims were to compare Tc-99(m)-(V)DMSA with Tc-99(m)-hydroxymethylene diphosphonate (Tc-99(m)-HDP) in bone metastases, to assess its value in imaging of bone metastases, and to assess the prospects of the P-emitting analogues Re-186/188-(V)DMSA as palliative agents for painful bone metastases. Ten patients confirmed by a Tc-99(m)-HDP bone scan to have bone metastases secondary to carcinoma of the prostate, lung or breast were injected with Tc-99(m)-(V)DMSA (600 MBq). Whole-body scans acquired at 3 and 24 h were compared with the Tc-99(m)-HDP bone scans. Tc-99(m)-(V)DMSA showed high soft tissue background, kidney retention and avid uptake in most bone metastases: 86% of bone lesions identified on bone scans were detected with Tc-99(m)-(V)DMSA. The lesion-to-normal ratios were comparable to or lower than those for Tc-99(m)-HDP at 3 h, but increased by 24 h. Instances of abnormal uptake in liver, primary lung tumour, lymph nodes and pleural effusion were observed. We conclude that Tc-99(m)-(V)DMSA is a tracer for bone metastases (with lower sensitivity than Tc-99(m)-HDP) and soft tissue tumours. If Re-186/188-(V)DMSA behave similarly, they may find use in therapy for soft tissue tumours and bony metastases.

AB - Pentavalent Tc-99(m)-dimercaptosuccinic acid (Tc-99(m)-(V)DMSA) has an established role in imaging medullary thyroid carcinoma. There have been case reports of uptake in bone metastases. Our aims were to compare Tc-99(m)-(V)DMSA with Tc-99(m)-hydroxymethylene diphosphonate (Tc-99(m)-HDP) in bone metastases, to assess its value in imaging of bone metastases, and to assess the prospects of the P-emitting analogues Re-186/188-(V)DMSA as palliative agents for painful bone metastases. Ten patients confirmed by a Tc-99(m)-HDP bone scan to have bone metastases secondary to carcinoma of the prostate, lung or breast were injected with Tc-99(m)-(V)DMSA (600 MBq). Whole-body scans acquired at 3 and 24 h were compared with the Tc-99(m)-HDP bone scans. Tc-99(m)-(V)DMSA showed high soft tissue background, kidney retention and avid uptake in most bone metastases: 86% of bone lesions identified on bone scans were detected with Tc-99(m)-(V)DMSA. The lesion-to-normal ratios were comparable to or lower than those for Tc-99(m)-HDP at 3 h, but increased by 24 h. Instances of abnormal uptake in liver, primary lung tumour, lymph nodes and pleural effusion were observed. We conclude that Tc-99(m)-(V)DMSA is a tracer for bone metastases (with lower sensitivity than Tc-99(m)-HDP) and soft tissue tumours. If Re-186/188-(V)DMSA behave similarly, they may find use in therapy for soft tissue tumours and bony metastases.

U2 - 10.1097/00006231-199710000-00003

DO - 10.1097/00006231-199710000-00003

M3 - Article

SN - 0143-3636

VL - 18

SP - 907

EP - 914

JO - Nuclear Medicine Communications

JF - Nuclear Medicine Communications

ER -