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Excerpt
Aim To determine the value of combined planar and tomographic radionuclide imaging with 99mTc(V)-dimercaptosuccinic acid (99mTc(V)-DMSA) and 111In-octreotide in the longitudinal follow-up of patients with MTC.
Method Scan results were reviewed in 19 patients (17 female, 2 male, mean age 68 years). Seventy combined studies were performed over a mean period of 7.5 years (range 1–18 years). Studies were repeated at 6-month intervals if calcitonin levels were rising rapidly and at 1-year intervals if calcitonin levels were elevated but plateaued or rising slowly.
Results Twenty-eight (37.3%) combined studies were abnormal and, similarly, 28 (37.3%) were negative. In 15 (20%) combined studies the 99mTc(V)-DMSA alone was positive and in 4 ( 5.3%) the 111In-octreotide alone was positive. In 11 99mTc(V)-DMSA and 7 111In-octreotide studies the tomographic study alone was positive. In 13 patients, the combined studies became positive during the course of follow-up.
Conclusion Combined imaging with planar and tomographic 99mTc(V)-DMSA/ 111In-octreotide identified sites of recurrent disease in 62.7% of follow-up studies performed. Radionuclide imaging provides an effective method of monitoring MTC patients with biochemical evidence of relapse.
