title: False-negative scintigraphy with Tc-99m sestamibi in stage IV neuroblastoma.
abstract: Tc-99m sestamibi, originally developed for myocardial studies, has been used as a tumor-seeking agent. Recently, the agent also was reported to be a functional tracer to predict multidrug resistance-related p-glycoprotein expression in tumor tissue. The current report presents the authors' experience with sestamibi tumor scintigraphy in a neuroblastoma. Although I-131 MIBG tumor imaging and Tc-99m MDP bone scanning accurately demonstrated the extent of the disease, Tc-99m sestamibi showed no accumulation in primary and metastatic foci. Lack of sestamibi uptake was initially thought to be suggestive of failure to respond to chemotherapy because of p-glycoprotein expression. However, the patient responded well to chemotherapy and complete remission was achieved. The failure of Tc-99m sestamibi to detect a neuroblastoma and the lack of sestamibi accumulation in the tumor may not always be related to chemotherapy resistance.
authors.affiliation: Medical Faculty of Nuclear Medicine, Ege University, Izmir, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Ozcan
authors.forename: G
authors.initials: G
authors.lastname: Erenel
authors.forename: S
authors.initials: S
authors.lastname: Aksoylar
authors.forename: S
authors.initials: S
authors.lastname: Kansoy
authors.forename: Z
authors.initials: Z
authors.lastname: Burak
authors.forename: H
authors.initials: H
authors.lastname: Ozkiliç
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary; D002675:Child, Preschool; D019008:Drug Resistance, Neoplasm; D005188:False Negative Reactions; D019204:GTP-Binding Proteins / Q000235:genetics; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012074:Remission Induction; D013669:Technetium Tc 99m Medronate; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D019204:GTP-Binding Proteins; D013669:Technetium Tc 99m Medronate