Pheochromocytoma scanning using 131J-meta-benzylguanidine was done in one patient with metastasizing paraganglioma, one patient with multiple endocrine neoplasia type IIb. No activity of tumour tissue could be demonstrated in the patient with metastasizing paraganglioma, whereas the pheochromocytoma could be clearly defined in the patient with multiple endocrine neoplasia type IIa. The female with multiple endocrine neoplasia type IIb showed a suspect space-occupying lesion of the left adrenal using computed tomography. Pheochromocytoma could be excluded by 131J-benzylguanidine scanning, selective estimation of catecholamines in adrenal venous blood as well as the glucagon stimulation and clonidine suppression.

After 2 years with a normal post-transplant course a 45-year-old man showed an elevated creatinine level (4.5 mg/dL). Transplantation had been neccessary because of progressive glomerulonephritis. Renal transplant imaging was obtained with 150 Mbq Tc-99m MAG3. The perfusion images showed radionuclide accumulation in the area of the upper abdominal aorta and delayed perfusion of the right iliac artery. Accumulation of Tc-99m MAG3 in the transplant was slow and no filling of the bladder could be observed. Immediately after imaging, the patient developed acute hemorrhagic shock. At emergency surgery, a long dissecting and ruptured aneurysm of the abdominal aorta was seen causing delayed and reduced blood flow in the right iliac artery and the transplant.

289 patients were simultaneously investigated with a partially shielded whole body counter (Oberhausen) and in camera technique to correlate the values of the MAG3-clearance. Good correlation was found for the often used times schedules of taking blood samples. Late blood samples increase high clearance values in both methods slighly. The shape of the ROI has no influence using camera technique. We conclude, that camera technique can replace the Oberhausen method with a partially shielded whole body counter.

There is little experience with imaging of thyroid carcinoma tissue by somatostatin receptor scintigraphy. Our case report describes an acromegalic patient, in whom 111In pentetreotide scintigraphy did not only demonstrate a receptor-positive pituitary tumor but also visualized metastases from a papillary thyroid carcinoma which had no correlate in radioiodine scintigraphy carried out under hypothyroid conditions. The possible role of this radiopharmaceutical in dedifferentiating thyroid carcinoma is discussed for its usefulness in tumor localisation and its predictive value for the outcome of an octreotide therapy.

ZusammenfassungZur Darstellung von Schilddrüsenkarzinomgewebe mittels Somatostatin-Rezep-torszintigraphie liegen bisher wenig Erfahrungen vor. Wir stellen die Kasuistik einer akromegalen Patientin vor, bei der die 111 In-Pentetreotide-Szintigraphie -außer einem Somatostatinrezeptor-positiven Hypophysentumor - auch Metastasen eines papillären Schilddrüsenkarzinoms darstellte, die im unter Hypothyreose angefertigten Radiojodszintigramm kein Korrelat fanden. Der mögliche Stellenwert dieses Radiopharmazeutikums bei entdifferenzierenden Schilddrüsenkarzinomen wird in bezug auf den lokalisationsdiagnostischen Nutzen sowie auf die prädiktive Aussagekraft hinsichtlich des Erfolges einer Octreotide-Langzeit-behandlung diskutiert.

On domestic pigs 2/3 gastrectomies with retention and elimination of the duodenal passage were carried out. Postprandial gastric emptying was measured scintigraphically for 4 h and compared with a control group (laparotomy only). For the semi-solid, 99mTc-labeled test meal delayed gastric emptying after elimination of the duodenal passage by Roux reconstruction could not be shown. There was no difference in gastric emptying between B-I and Roux-en-Y partial gastrectomy. Also alteration of the length of the jejunum loop from 40 to 20 cm after Roux-en-Y reconstruction had no influence on gastric emptying. Roux reconstruction (40 cm loop) in combination with truncal vagotomy led to a non-uniform gastric emptying, but there was a statistically proven acceleration compared with B-I resection. After 240 min the mean residual intragastric activity of the control group (n = 5) was 47.8%, 78.9% after B-I resection (n = 5), 59% after Roux reconstruction with 40 cm jejunal loop (n = 5), 38.1% after Roux reconstruction with 20 cm jejunal loop (n = 5) and 20.9% after Roux-en-Y (40 cm loop) with truncal vagotomy (n = 4).

The radiological and scintigraphic findings of 26 patients with histologically proven Ewing's sarcoma were analysed. Three-phase bone scan should be done early in patients presenting with pain and normal radiographs. Perfusion and metabolism of a bone lesion can be assessed by skeletal scintigraphy. Bone metastases are first seen on bone scan. In the follow-up of the patient bone scans at regular intervals are essential to detect bone metastases and tumour recurrence. The scintigraphic findings have to be correlated with radiographs and if these are negative a short-term control is indicated. Three-phase bone scans can assess the tumours response to therapy.

The activity concentrations of 99mTc-HMPAO in brain after intravenous injection were evaluated in 25 patients using SPECT. With additional first pass studies of heart and brain with the short lived isotope 195mAu, the cardiac output and the mean cerebral transit times of the patients were measured a short time before the HMPAO injection. The time dependence of 99mTc-HMPAO activity in the brain was registered during the first 5 min after injection over both hemispheres. Using a simplified three compartment model it was possible to calculate the mean retention fraction of HMPAO in brain from the time activity curves. It could be shown that the regional cerebral blood flow in ml/min per 100 g can be calculated from the activity concentration of HMPAO in the brain, the cardiac output and the retention fraction. In 15 of the 25 cases the rCBF was measured using the planar 133Xe inhalation method as a reference. We found a significant correlation between the mean hemisphere CBF from our method and the mean hemisphere grey matter CBF from the Xenon method with a correlation coefficient of 0.73.

The radiological and scintigraphic findings of 26 patients with histologically proven Ewing's sarcoma were analysed. Three-phase bone scan should be done early in patients presenting with pain and normal radiographs. Perfusion and metabolism of a bone lesion can be assessed by skeletal scintigraphy. Bone metastases are first seen on bone scan. In the follow-up of the patient bone scans at regular intervals are essential to detect bone metastases and tumour recurrence. The scintigraphic findings have to be correlated with radiographs and if these are negative a short-term control is indicated. Three-phase bone scans can assess the tumours response to therapy.