These results indicate that scanning with [(123)I]VEGF(165) can visualise gastrointestinal tumours and metastases expressing receptors for VEGF(165). [(123)I]VEGF(165) receptor scintigraphy may be useful for visualisation of tumour angiogenesis.

Summary:Aim: The clinical value of combined XCT/SPECT technology in a single device in patients undergoing 123I-MIBG scintigraphy was analyzed. Methods: 31 patients (19 men, 12 women; mean age 55 years, range: 31-79 years) demonstrating focal accumulation in planar 123I-MIBG scan were further investigated with a double headed gamma camera with an X-ray tomograph mounted on the same gantry (GE Medical Systems, Millennium VG with Hawkeye, Milwaukee, USA) for anatomical definition of the focal 123I-MIBG uptake. The patients were referred to 123I-MIBG scintigraphy because of biochemically (81%) and/or clinically (19%) suspected pheochromocytoma. Results: In 23 out of 31 patients (74%) the fused images demonstrated physiological accumulation (i. e. intestinal, renal) of 123I-MIBG. In two patients (6%) suspected adrenal MIBG-accumulation was caused by inhomogeneous liver uptake. In two patients (6%) focal abdominal accumulation was correctly localised in the adrenal glands. Furthermore, the differentiation of bone metastasis from a local recurrence for phaeochromocytoma was accurately possible for two patients (6%). Adrenal lesions mimicking liver foci were correctly localised in the remaining two patients (6%). Conclusion: Our study demonstrates the clinical value of XCT/SPECT in a single device in patients demonstrating focal 123I-MIBG uptake in planar scintigraphy. The combined XCT/SPECT technology provides a higher diagnostic accuracy.

Significantly increased VEGF concentrations were found in bloody cyst fluid and in cyst fluid of thyroid adenomatous goiter, compared with VEGF concentrations in degenerative thyroid cysts. Our results suggest that VEGF may play an important role in the pathogenesis of thyroid cyst fluid.

Summary: Aim: Although parathyroid scintigraphy using 99mTc-sestamibi is considered the best preoperative localization method for hyperfunctioning parathyroid tissue it lacks the anatomical details required for successful, minimal invasive surgery of ectopic parathyroid lesions. This study presents the role of combined SPECT/X-ray-CT imaging in a single device for localization of mediastinal parathyroid glands. Methods: 99mTc-sestamibi SPECT/ X-ray-CT was performed by gamma camera-mounted anatomical X-ray tomography (GMAXT; GE Medical systems, Millenium VG with Hawkeye) in four patients with ectopic parathyroid glands (two patients with primary, two with persistent secondary hyperparathyroidism). The device contains an X-ray tube and a set of detectors that rotate around the patient combined with a gamma camera. For comparison with GMAXT additionally high resolution computed tomography images of the neck and mediastinum were performed. Results: Correct preoperative localization was achieved. The parathyroid glands were located in the anterior mediastinum. High resolution computed tomography could not provide further details. Three patients were operated by a minimal invasive open and one patient by a transsternal approach because of concomitant aortic valve replacement. Conclusion: 99mTc-sestamibi/X-ray-CT fusion imaging in a single device can accurately localise ectopic or supernumerary mediastinal parathyroid tumours in primary and secondary hyperparathyroidism. Morbidity, radiation exposure, time, and costs are reduced by avoiding multiple diagnostic examinations and minimal invasive parathyroid surgery becomes possible.

F ALSE-POSITIVE 131 I whole-body scan (WBS) findings mimicking metastases of differentiated thyroid carcinoma have long been reported. We now report a case of falsepositive 131 I scan in a 62-year-old female who underwent radioiodine treatment after surgery for lung metastasis of papillary thyroid cancer. Three days after therapeutic administration of 5550 MBq 131 I a WBS was performed. While WBS revealed no 131 I accumulation in the lung, a focal retention was observed in the mid-thorax. A further anatomic clarification of this uptake has been undertaken with the novel x-ray-CT/SPECT technology in a single device (Millenium VG with Hawkeye, GE Medical Systems, Milwaukee, WI). The transmission/emission tomography of the thorax demonstrated the 131 I uptake being in the tracheobronchial region (Fig. 1). After detailed exploration this unusual accumulation is thought to be caused by the use of local aerosol *If you would like to submit an image for publication in "Images in Thyroidology," please send two copies of high-quality black-andwhite images with a short legend. In special circumstances color figures will be published. Please inquire for details from the Section Editor. All material must be original and neither published nor submitted elsewhere. The legend should give relevant clinical information. The entire legend should be typed double-spaced, and should be no more than 200 words. Send all submissions to Yaron Tomer, M.D.,