99mTc pertechnetate thyroid scan leads to serendipitous detection of metastatic thyroid cancer

99mTc pertechnetate is considered insensitive in detecting thyroid carcinoma metastases. We report the case of a 71-year-old male patient, in whom metastasis of an unknown thyroid cancer was diagnosed incidentally on a routine 99mTc pertechnetate scan, performed for the assessment of nodular thyroid disease. Marked tracer accumulation was unexpectedly noted on the left frontal region, where a palpable, painless, soft tissue mass was present. Surgical excision of the mass revealed metastatic poorly differentiated thyroid carcinoma synchronous to soft tissue and adjacent bone.     

Dramatic intestinal uptake of99mTc pertechnetate in a pediatric patient with enteritis

A pediatric patient with enteritis, which showed dramatically diffuse uptake of 99mTc pertechnetate in the intestine, is reported. Repeated study after medical treatment exhibited complete disappearance of the intestinal uptake. 99mTc pertechnetate scintigraphy has the potentiality for diagnosing and monitoring active enteritis.     

Comparison of CVA imaging with 99mTc phosphates, 99mTc pertechnetate,and computed tomography

Summary A retrospective study was made of 111 patients who underwent computed tomography (CT) and nuclear brain scans, with both pertechnetate and phosphate bone agents (PHOS), within 7 days of each other. Specifically, 78 patients who had a recent cerebral vascular accident (CVA) were compared. There were no significant sensitivity differences between the methods. While these studies appear complementary, the most important criterion is the time after onset when the studies were performed. The axiom if the intensity of the phosphate scan exceeds that of the pertechnetate, the lesion must be a CVA is true, only if the study is performed within 4 weeks of onset. The most economical method for optimum detection of CVA, with avoidance of frequent errors, is an early CT followed by a PHOS brain scan about 14 days after ictus in those that have an initial negative CT.     

Normal values of [99mTc]pertechnetate uptake and excretion fraction by major salivary glands

The assessment of the functional status of the salivary glands has been used in the scintigraphic evaluation of xerostomia. Several quantitative methods derived from standard dynamic scintigraphy have been suggested. However, the indices proposed are quite variable and unlikely to be useful in clinical practice.The objectives of this study were to obtain reference values of major salivary glands uptake and excretion fraction in healthy subjects and to obtain normal ratios of Tc-pertechnetate uptake by the major salivary glands in comparison to the thyroid gland uptake. The standardization of these values has the purpose of making this evaluation faster and more objective.Fifty volunteers without clinical evidence of xerostomia or thyroid disease underwent static salivary glands scintigraphy with Tc-pertechnetate. Static images were obtained at 20 minutes and then at 3 minutes after oral stimulation with lemon juice. Percent uptake, excretion fraction and salivary gland to thyroid ratio rates were calculated for the parotid and the submandibular glands.The mean of the uptake values at 20 minutes for the right and left parotid glands were respectively 0.31% and 0.26%, and for the submandibular glands 0.15%. The excretion fraction of the tracer after the lemon juice stimulation was 70% for the parotids glands, 50% for the right and 49% for the left submandibular glands. The mean+/-SD salivary gland to thyroid count ratio was 0.79+/-0.45 for the right parotid, 0.78+/-0.5 for the left parotid, 0.67+/-0.33 and 0.66+/-0.34 for the right and left submandibular glands, respectively.Salivary glands scintigraphy with uptake and excretion fraction calculation is an easy to perform, non-invasive and objective method to investigate salivary glands function. These findings help the nuclear physician to interpret salivary gland scintigraphy more objectively, even in patients with thyroid gland dysfunction in whom Tc-pertechnetate thyroid uptake may be abnormal.     

An evaluation of 99mTc pertechnetate scanning for the detection of coeliac disease and Crohn's disease

To investigate the use of abdominal scintiscanning in the detection of small bowel pathology, the accumulation of pertechnetate (99mTc), following intravenous injection, has been studied in 21 patients with coeliac disease, 13 patients with Crohn's disease and in 83 control subjects without known small bowel disease. Although a trend for a greater accumulation of 99m Tc was noted in patients with coeliac disease and Crohn's disease compared with controls (P less than 0.025) there was a large overlap in individual studies. Under the conditions of this study the accumulation of 99mTc by the small bowel did not provide a reliable diagnostic test for coeliac disease or Crohn's disease of the small intestine. The accumulation of 99mTc pertechnetate by normal small bowel suggests that scintiscanning with this radiopharmaceutical does not provide a consistently reliable method for the detection of small bowel pathology.     

An evaluation of 99mTc pertechnetate scanning for the detection of coeliac disease and Crohn's disease

To investigate the use of abdominal scintiscanning in the detection of small bowel pathology, the accumulation of pertechnetate (^99mTc), following intravenous injection, has been studied in 21 patients with coeliac disease, 13 patients with Crohn's disease and in 83 control subjects without known small bowel disease. Although a trend for a greater accumulation of ^99mTc was noted in patients with coeliac disease and Crohn's disease compared with controls (P(0.025) there was a large overlap in individual studies. Under the conditions of this study the accumulation of ^99mTc by the small bowel did not provide a reliable diagnostic test for coeliac disease or Crohn's disease of the small intestine. The accumulation of ^99mTc pertechnetate by normal small bowel suggests that scintiscanning with this radiopharmaceutical does not provide a consistently reliable method for the detection of small bowel pathology.