Lymphoscintigraphy for interpretation of changes of cervical lymph node function in patients with oral malignant tumors: comparison of Tc-99m-Re and Tc-99m-HSA-D.
OBJECTIVE
The purpose of this study is to compare the usefulness of technetium-99m-rhenium colloid (Tc-99m-Re) and technetium-99m-human serum albumin diethylene-triamine-pentaacetic acid (Tc-99m-HSA-D) as lymphoscintigraphic agents and to discuss the significance of lymphoscintigraphy in comparison with computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography (US).


METHODS
Dynamic and static lymphoscintigraphies were performed with Tc-99m-Re and Tc-99m-HSA-D. The usefulness of the 2 agents was evaluated statistically in comparison with pathologic findings and palpation. The significance of lymphoscintigraphy is discussed in comparison with CT, MRI, and US (by the literature of CT, MRI, and US).


RESULTS
Lymphoscintigraphy was superior to palpation, and Tc-99m-Re was superior to Tc-99m-HSA-D in accuracy, specificity, and the incidence of true-positive and false-positive. Statistical significance was shown between the static lymphoscintigraphy with Tc-99m-Re and palpation. The reliability of lymphoscintigraphy seemed to be slightly inferior to CT and MRI in specificity and accuracy. However, lymphoscintigraphy had some advantages that CT and MRI lacked; for example, it showed very high sensitivity (100%) and no false-negative (0%). It also showed changes of lymph node function, showed all levels of neck nodes at one time, and showed a possibility of detecting small lymph node metastases.


CONCLUSIONS
Lymphoscintigraphy was more useful than palpation in detecting lymph node metastases, and Tc-99m-Re was superior to Tc-99m-HSA-D as an agent. Lymphoscintigraphy is significant when it is performed as a preliminary examination before CT or MRI.
Sato
T
T
Kagoshima University Dental School and Medical School, Department of Dental Radiology, Japan. sato@denta.hal.kagoshima-u.ac.jp
Yamaguchi
K
K
Morita
Y
Y
Noikura
T
T
Sugihara
K
K
Matsune
S
S
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000473:pathology; D009333:Neck; D010173:Palpation; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012211:Rhenium; D012680:Sensitivity and Specificity; D017556:Technetium Compounds; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D013668:Technetium Tc 99m Aggregated Albumin; C057162:technetium Tc 99m DTPA HSA; C030576:technetium Tc 99m rhenium colloid; D012211:Rhenium; D016284:Technetium Tc 99m Pentetate