[en] Radionuclide bone scanning carried out with technetium radiopharmaceutics detects almost all prostatic carcinomas osseous metastases. It is easy to recognize focal areas of increased tracer uptake or a diffuse increased uptake, and the test provides a synthetic view of the entire skeleton complementary bone radiographs are necessary if the diagnosis remains doubtful, if mechanical complications are searched and if there is a post-radiotherapeutic decrease of the tracer uptake. A bone scan is necessary before the radical treatment of the primary tumour, in order to rule out the possibility of bone metastases. The initial bone scan has also a pronostic value. However, in the follow-up of initially non-metastatic patients, serial bone scans should not be realized when clinical symptoms or biological abnormalities lack. Bone scintigraphy is also useful to monitor the course of bone metastases under treatment especially when the value of new therapeutic agents is investigated

No abstract available

[en] Over a 4 years period (1993-1996) osseous scintigraphy was used systematically in the account of extension for 159 patients (157 F and 2 M) and renewed for 61 patients presenting a new event (osseous pain, recurrence, elevation of CA 15-3). In the account of extension the scintigraphy is positive in 2.7% (2/72) of patients with a small tumor (T0, T1, T2). This percentage is significantly different (p = 10^-2) of that obtained for T3 (6/32 = 19%), T4 (11/44 = 25%) or TX (4/11 = 36%). Although, the relationship between the positivity of osseous scintigraphy and elevation of CA 15 - 3 is significant (p = 10^-7), the sensitivity of CA 15 - 3 as compared with the scintigraphy is only 47% (9/19). Among, the 29 cases of positive osseous scintigraphy with a CA 15 -3 normal, the clinical evolution and/or radiological exploration show that 18 cases are false negatives of CA 15 - 3. For 32 suspected scintigraphies the radiography is normal in 11 cases. In 4 cases the radiology or the scanner became positive after a delay of 5 to 13 months. Besides, the percentage of scintigraphic false positives is high in case of isolated lesion (100% for ribs, 42% for the axial skeleton and 57% for extremities or skull). In conclusion, in the extension account the osseous scintigraphy finds its unique interest in case of large tumors (T3, T4). The high sensitivity of scintigraphy suggests its utilization in surveillance of high risk forms if there exists a real benefit of patient in terms of survival

[en] The aim of our study is to estimate the reproducibility and the exactitude of three algorithms to determine with ^99mTc-DTPA the relative function of each kidney. Methods: a prospective study was carried out in voluntary patients. Reproducibility was studied in 11 patients who underwent had two examinations with ^99mTc-DTPA. Exactitude was evaluated in 35 patients who had an additional scintigraphy with ^99mTc-DMSA taken as a reference. To determine the relative renal function with ^99mTc-DTPA, three algorithms using various background subtraction methods and time intervals were applied. Results and conclusion: the method of the integral was the most reproducible and exact. It was little influenced by the choice of the interval of time. The reproducibility and the exactitude of the Patlak method were worse, especially in case of renal insufficiency or hydronephrosis. A high background and poor counting statistics explain why Patlak was less powerful with ^99mTc-DTPA than with ^99mTc-MAG3. The method of the slopes should not be recommended any more. (author)

[en] Since 1987, with the use of a gamma camera coupled with a computer, 92 oesophageal cinescintigrams have been made for the purpose of investigating refluxes in patients with pulmonary or digestive pathology. Where refluxes are present, the scintigraphic parameters are compared with the clinical and fibroscopic data. (author). 3 refs

[en] The authors evaluate the contribution of the ultrasensitive thyroid stimulating hormone (TSH) immunoradiometric assay technique to thyroid pathology. They studied 547 patients over a period of two years (1986-1987). These patients were mostly from regions where goitre is endemic. They underwent clinical examination and scintigraphic tests, and their hormone levels were determined (total T4 and TSH). Ultrasensitive TSH was found to give very good results in cases of clinically unequivocal and in equivocal hypothyroidism. In cases of hyperthyroidism such exceptionally good results were noted only in cases where toxic nodules were present. In Basedow's disease the performance of ultrasensitive TSH was close to that of T4. In cases of equivocal hyperthyroidism, ultrasensitive TSH does not make it possible to dispense with the TRH test. (author). 7 refs, 5 tabs

[en] Full text of publication follows. Aim: to describe an unusual case of follicular carcinoma of the thyroid with uncommon metastases at the left atrium, the pulmonary vessels, the right eye and a subcutaneous mass. Materials and methods: the patient record was reviewed retrospectively. We analysed clinical outcomes and thyroglobulin rate as well as imaging findings after radio-iodine therapy. Results: we report the case of 43-year-old woman operated in 1995 for multi-nodular goitre by total thyroidectomy. Histopathologic findings were typical of follicular thyroid carcinoma with vascular invasion. The patient was then lost of sight and consulted in 2000 for a neck swelling. She was operated again for lymphadenectomy with resection of two peri-jugular tumoral masses that deviate vascular axes. Histopathologic findings concluded for residual follicular thyroid carcinoma with insular component without lymph node metastasis. The initial chest CT revealed a macro-nodular lung miliairy and the whole body scan post 100 mCi Iodine-131 showed intense cervical uptake and multiple bilateral thoracic fixations. The evolution after 10 cures of Iodine-131 has been marked by a persistently high thyroglobulin levels superior to 800 ng/ml with disappearance of cervical uptake and the persistence of pulmonary fixations. Bone scintigraphy scan was negative. Later, the patient complained of a decreased visual acuity. The last whole body SPECT/CT scan revealed multiple fixations of I-131 located at the right eyeball, lungs, left atrium, liver, sacrum as well as an abdominal subcutaneous solid mass. MRI confirmed a right choroid metastasis. Conclusion: follicular thyroid carcinoma comprises 15% of all thyroid cancers and usually metastases to the lymph nodes, lungs and bone. Other rare sites of metastases are the brain, pituitary, maxilla, larynx, and thymus. Distant metastases of these sites, particularly choroidal are exceptional. Metastatic cardiac involvement occurs most often during the terminal stage. They are frequently asymptomatic, but when symptoms develop these tend to be severe and often fatal. To our knowledge, only a few cases have been reported in the entire literature. Our case is unique in the presence of metastases in cardiac, choroidal and subcutaneous sites. We highlight the contribution of the SPECT/CT in the assessment of these distant metastases. (authors)

No abstract available

[en] Published in summary form only

[en] The cyclotron facility, essentially for medical use, is far from being a simple establishment of a dedicated device to accelerate particles producing a beta plus emitter radioelement. The cyclotron site encompasses more over all necessary equipments for the production and the quality control of considered radiotracer that ¹⁸FDG is just one example. This facility is subject to strict standards in terms of radiopharmaceutical production, radiation level, pressure level and airflow resulting in the production of a drug submitted to the MA (Marketing Authorization). These multiple factors directly influence the final cost of the dose that remains to be reachable by the patient. The aim of this work is to estimate the cost of a dose of ¹⁸FDG to ensure financial viability of the project while accessible to the patient. The cost of the facility will entail the following: buildings and utilities, equipment and operational cost. This calculation is possible only if we define in advance the type of cyclotron, which is bound to the market needs in particular the number of PET facilities, the number of scans per day and the radioactive decay of radioelement. Our study represents a simulation that considers some hypothesis. We assumed that the cyclotron is installed in Sousse and that the PET facilities number (positon emission tomography) is 6 in which 4 are located 2 hours away. For a PET scan, the average dose per patient is about 350 MBq (5 MBq/kg) and the exam duration is about 45 minutes. Each center performs 10 tests per day. In terms of fees, we considered device and building's cost, facility amortization, consumables (target, marking accessories), maintenance, remuneration expense and the annual electricity consumption. All our calculations have been reported to the number of working days per year. The estimates were made outside the customs duties and technical assistance that may last up to 2 years. Requirements and needs were estimated at 5.4 curies per day. For accomplishing that, a non self-shielded cyclotron with energy under 20 MeV is required. The daily amount of such production is estimated to 4000 dollars. The numerous experienced scan daily have an immediate impact on the price of the dose because of their cost which vary between 80 $ (50 exams per day) and 200 $ (only 20 exams per day). Our estimated price, including the cost of technical support, is too close to the price fixed by two neighbor countries (Egypt and Jordan) which corresponds to 300 dollars for the dose. The daily number of doses taken will determine the financial viability. (Author)