Tc-99m DTPA Used as Reference Imaging to Evaluate the Distribution of Other Tumor-seeking Tracers in Tumors Associated With Neurofibromatosis

Abstract

Two patients with multiple benign and malignant tumors associated with neurofibromatosis underwent radionuclide imaging with Tc-99m DTPA, Tl-201, and Ga-67. In these patients, Tc-99m DTPA accumulated intensively in both the benign and malignant tumors and localized and defined the extent of every tumor. In contrast, Ga-67 and Tl-201 uptake was seen only in focal areas of tumor where there was malignant transformation or at sites that showed progressive tumor growth. Tc-99m DTPA imaging accurately demonstrated areas of neoplastic involvement and identified the areas that would be seen with the other two tracers in individual tumors. Tc-99m DTPA may not always be used for the differential diagnosis of malignant and benign tumors of neurofibromatosis, but it can provide a reference pattern for imaging to evaluate accurately the distribution of Tl-201 and Ga-67 by mapping out the anatomic extent of these tumors.

Solitary Intraosseous Neurofibroma of the Frontal Bone -Case Report-

“…201 Tl-SPECT detects accumulation of radiotracer in both benign and malignant soft tissue neurofibroma, particularly any area of malignant transformation. 14,21) 201 Tl-SPECT has also detected high accumulation in benign tumors such as eosinophilic granuloma, 8) and even in skull cavernous hemangioma resulting in surgery because malignant tumor could not be excluded. 17) 201 Tl-SPECT cannot provide reliable malignancy estimates for skull tumor, but the possibility of malignancy could not be denied in the present case with high accumulation.…”

The correlation between clinical, nuclear and histologic findings in a patient with Von Recklinghausen's disease

“…Areas of high-grade activity between larger areas of benign cells may be missed due to sampling error [ 10 ]. Therefore, various radionuclide imaging techniques have been described to detect the development of MPNST in patients with NF1 [ 3 , 11 , 12 ]. Because sarcomas have high glucose metabolic rates 18 fluorodeoxyglucose ( 18 FDG) positron emission tomography (PET) scanning is well established [ 1 , 4 - 6 , 13 ].…”