Robert S. Frankel

Gallium-67 scintigraphy in malignant melanoma

Gallium‐67 whole body scintigraphy was included in the diagnostic workup of 44 consecutive patients with biopsy proven malignant melanoma in order to study the uptake of this nuclide by known melanoma tissue and to objectively assess its value in the detection of known and unknown meta‐static disease.

Renal localization of gallium-67 citrate.

Renal localization of 67Ga citrate has been observed in 1.7% of 2,000 whole-body gallium scans in three major diseases: lymphoreticular neoplasms, leukemia, and malignant melanoma. Correlation of this finding with autopsy data in 13 cases revealed 9 with tumor and 2 with an inflammatory process. Findings in two cases were normal. In the remaining patients, correlation with abnormal urograms and laboratory data was poor. Nevertheless, gallium localization in the kidneys may be the first indicator of renal involvement with either tumor or inflammation.

Clinical Correlations of 67Ga and Skeletal Whole-Body Radionuclide Studies with Radiography in Ewing's Sarcoma

Twenty-seven patients with Ewings sarcoma were evaluated by whole-body radionuclide studies, using 67Ga citrate and 18F or 99mTc polyphosphate. Correlative diagnostic radiography was performed on all patients. Gallium scanning, bone scanning, and roentgen rays were of equal usefulness in diagnosing the primary lesion. Skeletal metastases were evaluated most effectively with bone scanning, 12 of 13 cases being thus detected, whereas 8 of 13 were detected on gallium images and 4 of 13 on radiographs. Lung metastases were found in 7 of 8 cases with radiography but in only 1 of 8 gallium scans.

“Normal” Bone Radionuclide Image with Diffuse Skeletal Lymphoma

A case of diffuse skeletal involvement by lymphoma is presented. Bone scan was interpreted as normal, but gallium scans and roentgenograms revealed the proper diagnosis. A possible explanation for this discrepancy is offered.

Brain Scintigraphy with 99mTc Pertechnetate, 99mTc Polyphosphate, and 67Ga Citrate

Nineteen patients with known or suspected neoplasms of the skull and/or brain were studied with 99mTc pertechnetate, 99mTc polyphosphate, and 67Ga citrate. Lesions of the calvaria were detected most accurately with 99mTc polyphosphate. In some cranial lesions, 67Ga citrate localized within the core, 99mTc polyphosphate outlined the periphery, and 99mTc pertechnetate demonstrated the entire affected area. In postcraniotomy patients, the combination of 67Ga citrate and 99mTc polyphosphate provided a basis for distinguishing the surgical scar from a recurrent intracranial tumor. Purely intracerebral lesions were generally poorly localized with 99mTc polyphosphate.

The significance of urinary bladder displacement noted on whole-body 18F bone scintigraphy.

Whole-skeletal scintigraphy was employed in a large group of patients with malignant lesions. An unusual pelvic distribution of 18F was noted in 3 cases. The images were initially interpreted as showing a pelvic bony lesion; however, the placement of the urinary bladder was in question, since each patient was known to have a pelvic tumor. Examination of the urograms in each case showed that the suspected abnormality was a displaced bladder. The necessity of correlating the appropriate roentgenographic studies with the radionuclide images is emphasized.